Is there an antidote for pokeweed?

Poisonous Ingredient

Poisonous ingredients include:

• Phytolaccatoxin
• Phytolaccigenin

Where Found

The highest amounts of poison are found in the roots, leaves, and stems. Small amounts are in the fruit.

Cooked berries and leaves (cooked twice in separate water) can technically be eaten. However, this is not recommended because there is no guarantee that they are safe. The roots should never be eaten.

Symptoms most often appear within 6 hours of ingestion.

Symptoms

Symptoms may include:

• Convulsions (seizures)
• Diarrhea, sometimes hemorrhagic (bloody)
• Headache
• Loss of consciousness (unresponsiveness)
  
• Low blood pressure
• Muscle spasms
• Nausea and vomiting
• Rapid pulse
• Slow or difficult breathing
• Stomach pain
• Weakness

Home Care

Seek immediate medical help. DO NOT make a person throw up unless told to do so by poison control or a health care provider.

Before Calling Emergency

Get the following information:

• Person's age, weight, and condition
• Time it was swallowed
• Amount swallowed
• Name and part of the plant that was eaten, if known

Poison Control

Your local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This national hotline number will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does not need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

What to Expect at the Emergency Room

The provider will measure and monitor person's vital signs, including temperature, pulse, breathing rate, and blood pressure. Symptoms will be treated as appropriate. The person may receive:

• Activated charcoal
• Blood and urine tests
• Breathing support, including oxygen through a tube through the mouth into the lungs, and a breathing machine (ventilator)
• Chest x-ray
• ECG (electrocardiogram, or heart tracing)
• Fluids by IV (through the vein)
• Medicines to treat symptoms
• Laxatives

Outlook (Prognosis)

How well you do depends on the amount of poison swallowed and how quickly treatment is received. The faster you get medical help, the better the chance for recovery.

Deaths have been reported. Improper cooking of leaves or eating some of the roots with the leaves can cause serious poisoning. Eating more than 10 uncooked berries can cause serious problems in children.

DO NOT touch or eat any plant with which you are not familiar. Wash your hands after working in the garden or walking in the woods.

References

Aronson JK. Phytolaccaceae. In: Aronson JK, ed. Meyler's Side Effects of Drugs. 16th ed. Waltham, MA: Elsevier B.V.; 2016:758-758.

Auerbach PS. Wild plant and mushroom poisoning. In: Auerbach PS, ed. Medicine for the Outdoors. 6th ed. Philadelphia, PA: Elsevier; 2016:374-404.

Graeme KA. Toxic plant ingestions. In: Auerbach PS, Cushing TA, Harris NS, eds. Auerbach's Wilderness Medicine. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 65.

Version Info

Last reviewed on: 11/13/2021

Reviewed by: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

What is Pokeweed Poisoning?

• Pokeweed (botanical name Phytolacca americana) is a toxic herbaceous plant that is native to North America. The fruits of the plant may resemble a bunch of grapes
• Pokeweed Poisoning is the accidental or intentional intake of the plant or plant product containing certain chemical compounds. All parts of this plant are poisonous, but most of the toxicity is confined to its roots
• The condition is diagnosed based upon the clinical history, combination of signs and symptoms, and additional tests (that may include, in some cases, radiological studies and laboratory tests)

Pokeweed Poisoning may be also referred to variously as the following:

• American Nightshade Poisoning
• Inkberry Poisoning
• Phytolacca Americana Poisoning
• Pigeon Berry Poisoning
• Poke Salad Poisoning
• Pokeberry Poisoning
• Pokeroot Poisoning
• Pokeweed Toxicity
• Redweed Poisoning
• Scoke Poisoning
• Virginia Poke Poisoning

What are the Causes of Pokeweed Poisoning?

• Pokeweed Poisoning is caused by the ingestion of pokeweed plant and related products
• This intake could be accidental, or in some cases intentional, to bring self-harm
• The toxicity of the plant is due to the chemicals phytolaccatoxin and phytolaccigenin, which are mainly contained in pokeweed roots, stems, and leaves
• In some parts of the world, the berries and leaves of the plant are cooked and consumed, since cooking thoroughly is known to neutralize the toxins present in the plant. However, in some cases, the poison is retained even after cooking, mostly due to impartial/improper cooking

Note: The compound can interact with other prescribed or non-prescribed medications in the body. Such interactions may enhance the therapeutic effects of other medications being taken, resulting in undesired side effects.

What are the Signs and Symptoms of Pokeweed Poisoning?

The signs and symptoms of Pokeweed Poisoning can vary from one individual to another. It may be mild in some and severe in others. Several systems of the body may be affected. In most cases, the symptoms may be seen within a few hours (up to 6 hours) of eating the plant product.

The signs and symptoms of Pokeweed Poisoning may include:

• Headache
• Nausea and vomiting
• Diarrhea (blood in stool)
• Stomach or abdominal pain
• Breathing difficulties
• Decreased heartbeat rate (heart block); increased pulse rate
• Reduced blood pressure (hypotension)
• Spasms in the muscles
• Seizures

How is First Aid administered for Pokeweed Poisoning?

First Aid tips for Pokeweed Poisoning:

• Call 911 or your local emergency help number immediately, for emergency assistance
• Call the Poison Control Center at 1-800-222-1222 (or your local poison control center) for further instructions
• Provide them with information such as the compound taken, quantity and time of ingestion, age, weight and general health status of affected individual
• Confirm that the airways are protected; also, ensure breathing and the presence of pulse
• Unless instructed by a healthcare professional, DO NOT induce vomiting in the affected individual
• Take individual to emergency room (ER) for further treatment
• Always try to take the plant or plant product to the ER

The emergency medical health professional might perform the following steps towards treating the condition:

• Gastric lavage for elimination of the substance from the stomach (irrigation using special solutions)
• Medically manage symptoms, such as abnormal heart rate and seizures
• Provide breathing support, if necessary
• Administer activated charcoal to avoid absorbance of the substance in the body
• Administer laxatives for elimination of the substance from the body
• Administer fluids by an intravenous drip line

Who should administer First Aid for Pokeweed Poisoning?

First aid for Pokeweed Poisoning is administered by healthcare professionals.

• The individual who is affected, or someone near, should call 911 for emergency assistance (or the local emergency number)
• They should also call the poison control center at 1-800-222-1222 (or the local poison control center) and follow instructions

What is the Prognosis of Pokeweed Poisoning?

• The prognosis of Pokeweed Poisoning is dependent on the amount of substance consumed, time between consumption and treatment, severity of the symptoms, as well as general health status of the patient
• If the individual can recover from the symptoms, with appropriate medication and early support, the outcome is generally good
• In case of severe symptoms, it may considerably worsen the outcome. Children are more vulnerable to the toxic effects of the plant and deaths have been reported (including in adults too)

In general, toxicities are common situations in the emergency departments. A majority of the cases are often not fatal, when appropriate treatment is given.

How can Pokeweed Poisoning be Prevented?

Pokeweed Poisoning can be prevented by:

• Avoiding eating wild berries and plants, especially if you have no information about them
• Following working in the garden or fields, hiking, or camping, always wash hands thoroughly, prior to eating anything
• Always follow instructions for usage of any health or cosmetic products
• Keeping cosmetics, medications, and other healthcare products out of reach of children in child-proof containers
• Being aware of basic first aid steps in case of an emergency (such as inadvertent poisoning)

It is important to give your healthcare provider a complete list of prescription and non-prescription medications that are being currently taken. This will help them in assessing the possible drug interactions within various medications and help avoid/prevent accidental or unintentional toxic drug effects.

What are certain Crucial Steps to be followed?

• Call 911 (or your local emergency number) for emergency assistance, if symptoms are life-threatening
• Call Poison Control Center at 1-800-222-1222 (or the local poison control center) and follow the recommend steps
• It would be helpful if the following information is readily available:
  • Type, amount and time of consumption of the substance
  • Age and weight of the individual
  • And, the overall health status of the individual

Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: July 6, 2017
Last updated: Feb. 28, 2018

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