Mandrake toxicity. A case of mistaken identity

A 31-year-old man ingested an unknown amount of mandrake plant purchased at a local health food store and came to the emergency department with severe nausea and vomiting. He was hospitalized overnight but recovered uneventfully without obvious adverse systemic effects. This plant was almost certainly Podophyllum peltatum based on chromatographic identification of podophyllotoxin in a sample. However, the patient had mistakenly believed he was taking the anticholinergic and hallucinatory plant Mandragora officinarum, which is also known as mandrake. Other users of herbal substances and authors of the medical literature have also confused these 2 versions of mandrake. Given the growing popularity of alternative therapies, physicians should understand the distinction between these substances and should be aware of the medical effects of other commonly used herbal remedies.