Intoxication with nutmeg: A case presentation and analysis of Swiss poisons information center (Tox Info Suisse) enquiries 2014–2023

Ingesting large quantities of nutmeg can cause psychoactive and hallucinogenic effects. A 23-year-old man on long-term fluoxetine and quetiapine who ingested 75 g of nutmeg with suicidal intent developed tachycardia and mydriasis four hours later, became somnolent after about 14 hours, and all symptoms resolved spontaneously within 26 hours. Analysis of enquiries to the Swiss national poison information center from 2014 to 2023 identified 236 patients (51% female, ages 0–85). The highest number of enquiries (30) occurred in 2020 and 2021, coinciding with a TikTok nutmeg challenge and increased home baking during the COVID-19 pandemic. Nutmeg intoxications usually show a mild course, and incidence may be subject to social influences.

Study at a glance

Abstract

Introduction: Nutmeg is a widely used culinary spice. When ingested in large quantities it has psychoactive and hallucinogenic effects. Case reports: We present the case of a 23-year-old man on long-term fluoxetine and quetiapine who ingested 75 g of nutmeg with suicidal intent. Four hours later, he presented himself to the emergency department of the nearest hospital with tachycardia and mydriasis. He was transferred to the intensive care unit of Cantonal Hospital Baselland for further monitoring where, approximately 14 h after ingestion, he became somnolent. All symptoms resolved spontaneously within 26 h.We also analyzed enquiries to the Swiss national poison information center (Tox Info Suisse) about possible nutmeg intoxication from 2014 to 2023. During this period, enquiries for 236 patients were made (51% female, 0 - 85 years old). The largest number of enquiries (N = 30) occurred during 2020 and 2021, coinciding with a TikTok nutmeg challenge and an increase in the popularity of home baking during the COVID-19 pandemic. Discussion: Nutmeg is a widely available household spice with ingredients that can cause toxic effects when ingested in large quantities. Intoxications usually show a mild course, as in the case we describe here, despite long term medication with fluoxetine. The analysis of enquires to Tox Info Suisse suggest that the incidence of enquiries about possible nutmeg intoxication might be subject to social influences.