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These combinations are not usually physically harmful, but may produce undesirable effects, such as physical discomfort or overstimulation. Extreme use may cause physical health issues. Synergistic effects may be unpredictable. Care should be taken when choosing to use this combination.
Psychological addiction potential is minimal due to the typically unpleasant nature of the experience. Recreational use is rare as effects are often described as mentally and physically distressing rather than rewarding.
Physical dependence can develop with chronic therapeutic use. Withdrawal symptoms include nausea, dizziness, vomiting, gastrointestinal disturbances, sweating, headaches, bradycardia, hypotension, and various neuropsychiatric manifestations. Severe symptoms may require medical attention.
Large doses can cause respiratory failure and death. Scopolamine has been implicated in criminal poisonings, though the doses required for lethality are substantially higher than those causing incapacitation.
| Species | Route | Value |
|---|---|---|
| mouse | oral | 1880 mg/kg |
| rat | oral | 1270 mg/kg |
| mouse | subcutaneous | 1650 mg/kg |
| rat | subcutaneous | 296 mg/kg |
CNS depression ranging from drowsiness to coma can occur with overdose; cognitive impairment and impaired ability to operate machinery are documented effects at therapeutic and higher doses.
Cardiovascular effects including tachycardia and supraventricular arrhythmias can occur at higher doses; bradycardia may follow initial tachycardia or appear during withdrawal.
Scopolamine can increase intraocular pressure and is contraindicated in angle-closure glaucoma; blurred vision and mydriasis occur with use.
Gastrointestinal effects including decreased bowel sounds and constipation can occur; these effects are typically associated with the anticholinergic mechanism rather than direct toxicity.
Urinary retention can occur as an anticholinergic effect, particularly at higher doses or in susceptible individuals.
Scopolamine is formally classified as a deliriant and can exacerbate psychosis and cause psychiatric reactions including hallucinations, confusion, agitation, and restlessness. Mass hospitalizations for psychosis have occurred following ingestion of scopolamine-containing substances; more than 20 people were hospitalized with psychosis in Norway in 2008 after ingesting counterfeit tablets containing scopolamine.
Seizures and seizure-like activity are documented neuropsychiatric effects but are rare, occurring in less than 0.1% of patients at therapeutic doses. Convulsions have been reported in overdose cases.
Plants naturally containing scopolamine, including Atropa belladonna (deadly nightshade), Brugmansia (angel's trumpet), Datura (jimsonweed), Hyoscyamus niger, Mandragora officinarum, Scopolia carniolica, Latua, and Duboisia myoporoides, have been recognized and utilized for various purposes in both…
Available as a prescription pharmaceutical product. Injectable formulations marketed for intramuscular, intravenous, and subcutaneous administration.
Approved by the FDA on December 31, 1979 for prevention of nausea and vomiting associated with motion sickness and surgical procedures. Available as prescription tablets, injections, and transdermal patches. Some transdermal formulations are marketed as over-the-counter products.
Transdermal therapeutic system available as an over-the-counter product without prescription requirement.
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