Anticholinergic syndrome after atropine overdose in a supposedly homeopathic solution: a case report

Background A 53-year-old male with no pre-existing conditions and no permanent medication presented to our emergency department with an anticholinergic syndrome including confusion, anxiety, ataxia and dysarthria after ingestion of a homeopathic solution containing Atropa belladonna extract supposedly in a D4 dilution. Methods Atropine sulphate was quantitatively analysed in serum and the homeopathic preparation via liquid chromatography/mass spectrometry. Results Analysis revealed concentrations of approximately 3 mg/mL atropine sulphate in the homeopathic solution and a serum level of 5.7 ng/mL (+/- 1.4) in the patient's blood proving a 600-fold overdose of atropine due to a production error of the homeopathic dilution. The patient was observed and recovered without further intervention. Conclusion Rare but possibly dangerous manufacturing errors should be considered when faced with symptoms occurring after ingestion of homeopathic or holistic remedies.

Automated summary

A 53-year-old male with no pre-existing conditions experienced anticholinergic syndrome after ingesting a homeopathic solution containing Atropa belladonna extract. Analysis revealed a 600-fold overdose of atropine in the solution and the patient's blood, likely due to a manufacturing error. The patient recovered without further intervention, highlighting the potential dangers of rare manufacturing errors in homeopathic remedies.