Buckwheat-Associated Acute Psychosis: A Case of Anticholinergic Syndrome

Buckwheat (Fagopyrum esculentum) is a seed increasingly used as a gluten-free alternative, particularly by individuals with gluten-sensitive enteropathy. While rich in vitamins and minerals, it may also contain toxic secondary metabolites. The authors present a case of a 49-year-old female patient, admitted to the emergency department with a four-hour history of psychomotor agitation, confusion, and mydriasis. Symptom onset occurred three hours after consuming buckwheat. Clinical examination revealed disorientation, agitation, and visual and auditory hallucinations, with mydriasis and tachycardia. Laboratory and imaging tests were unremarkable. Toxicology screening was negative for common substances of abuse. A diagnosis of acute psychosis secondary to buckwheat ingestion was made. Management included intravenous diazepam, leading to a favorable clinical outcome. Buckwheat may contain tropane alkaloids, which can be toxic to humans. Benzodiazepines were effective in managing acute psychosis. This case highlights the potential neuropsychiatric effects of buckwheat ingestion and the importance of considering dietary causes in the differential diagnosis of acute psychosis.