Nutmeg is obtained from the fruit (seeds) of Myristica fragrans, an evergreen tree native to the South Pacific islands, and is commonly used as a cooking spice. Nutmeg contains volatile terpenes and aromatic ethers and has been used to treat dyspepsia, musculoskeletal disorders and arthritis. Myristicin (A) and elemicin (B) are two of many pharmacologically-active chemical compounds found in nutmeg and have similar chemical structures to amphetamines and mescaline, respectively. Inebriant effects of nutmeg were reported as early as 1576. Nutmeg was an important trade item in the 15th and 16th centuries, and was used by slaves on the ships bringing nutmeg to Europe to precipitate a pleasant, euphoric feeling that relieved their weariness and pain. Nutmeg also became recognized for its ability to induce abortions. Although not a popular street drug today, nutmeg may be abused by those looking to alter consciousness with a readily available, legal substance. Intoxication requires 5-20 grams (1-4 teaspoons) of ground nutmeg, often administered as a tea. Onset of symptoms occurs within 3-6 hours and last for 12-24 hours, often followed by deep sleep. Toxic symptoms are dose-related and primarily anticholinergic, including dry mouth, GI upset, flushing, palpitations, agitation, blurred vision, miosis, hypotension, hypothermia, hallucinations, as well as coma and death. Detection of nutmeg-related compounds by laboratory testing is not readily available. Activated charcoal may be used to prevent absorption of recent ingestions, but clinical management is otherwise supportive.
- Ellenhorn’s Medical Toxicology, 2nd ed. Williams & Wilkins, 1997.