Peganum harmala intoxication, a case report

Document Type : Case report


1 Department of Pharmacodynamy and Toxicology, School of Pharmacy, Mashhad University of Medical Science, Mashhad, I. R. Iran

2 Pediatrician-Toxicology Fellowship of Toxicology ward of Imam Reza Hospital of Mashhad, Mashhad University of Medical Science, Mashhad, I. R. Iran


Objective: Peganum harmala (P. harmala), “Espand” in Persian, has small seeds and has been used in traditional medicine as emmenagogue and an abortifacient. It has various pharmacological effects such as antifungal, antibacterial, hypothermic, anticancer, antinociceptive, and reversible monoamine oxidase inhibition.
Case details: This case was a 45 years old woman who ingested about 50 grams seed of P. harmala for hypermenorrhae. She suffered nausea, vomiting, dizziness, tremor, ataxia, and confusion. On physical examination, she had hypotension (BP=90/60 mmHg) with normal heart rate (60 beat/min) and impaired knee to heel test. Her consciousness was reduced without any hallucination. Her laboratory test was normal. She was discharged at good condition 18 hours later.
Conclusion: In conclusion, physicians working in Iran and other regions that P. harmala is prescribed or used illegally, should know signs and symptoms of its toxicity in order to be able to deal with the emergencies, however, prognosis of these toxicity is not bad.


Ben Salah N, Amamou M, et al. 1986. A case of overdose with Peganum harmala L. J Toxicol Clin Exp, 6: 319-322.
Chen Q, Chao R, et al. 2005. Antitumor and neurotoxic effects of novel harmine derivatives and structure-activity relationship analysis. Int J Cancer, 114: 675-682.
el Bahri L and Chemli R. 1991. Peganum harmala L: a poisonous plant of North Africa. Vet Hum Toxicol, 33: 276-277.
Frison G, Favretto D, et al. 2008. A case of beta-carboline alkaloid intoxication following ingestion of Peganum harmala seed extract. Forensic Sci Int, 179: e37-43.
Herraiz T, Gonzalez D, et al. 2010. beta-Carboline alkaloids in Peganum harmala and inhibition of human monoamine oxidase (MAO). Food Chem Toxicol, 48: 839-845.
Jahaniani F, Ebrahimi SA, et al. 2005. Xanthomicrol is the main cytotoxic component of Dracocephalum kotschyii and a potential anti-cancer agent. Phytochemistry, 66: 1581-1592.
Mahmoudian M, Jalilpour H, et al. 2002 Toxicity of Peganum harmala: Review and a Case Report. Iran J Pharmaco Therap, 1: 1-4.
Marwat SK, Rehman Fu, et al. 2011. Chapter 70 - Medicinal and Pharmacological Potential of Harmala (Peganum harmala L.) Seeds. Nuts and Seeds in Health and Disease Prevention. San Diego, Academic Press: 585-599.
Pranzatelli MR and Snodgrass SR. 1987. Harmala alkaloids and related beta-carbolines: a myoclonic model and antimyoclonic drugs. Exp Neurol, 96: 703-719.
Puzii AD, Vecherkin SS, et al. 1980. Toxicity of the total alkaloids of the harmal. Veterinariia: 57-58.
Shi CC, Chen SY, et al. 2000. Vasorelaxant effect of harman. Eur J Pharmacol, 390: 319-325.
Yuruktumen A, Karaduman S, et al. 2008. Syrian rue tea: a recipe for disaster. Clin Toxicol (Phila), 46: 749-752.