Syrian rue seeds interacted with acacia tree bark in an herbal stew resulted in N,N-dimethyltryptamine poisoning.
Clinical toxicology (Philadelphia, Pa.) October 1, 2019 Chuan-Huai Liu, Wei-Lan Chu, Shu-Chen Liao et al. 10 citations
Two patients developed N,N-dimethyltryptamine (DMT) poisoning after consuming an herbal stew made from Syrian rue seeds (containing monoamine oxidase inhibitors) and Acacia tree bark (containing DMT). Laboratory analysis confirmed DMT and harmaline in their blood and urine. One patient had detectable DMT in serum (25 ng/mL) and more severe symptoms, including altered consciousness, rhabdomyolysis, and elevated liver enzymes, while the other had undetectable serum DMT and milder effects. The combination mimics taking DMT with a monoamine oxidase inhibitor, producing sympathomimetic toxicity. Physicians should consider unusual herbal preparations as potential causes of drug-drug interactions and poisoning.