Calabar Bean

Generic name: Physostigma Venenosum Balf. F.
Brand names: Calabar Bean, Chop Nut, Esere Nut, Faba Calabarica, Ordeal Bean, Physostigma

Usage of Calabar Bean

Anticholinergic toxicity

Physostigmine alone is an acetylcholinesterase inhibitor that prolongs the neuronal activity of acetylcholine. Given its ability to cross the blood-brain barrier, it is used to reverse the CNS toxicity (eg, anxiety, delirium, disorientation, hyperactivity, hallucinations, and seizures) of anticholinergic drugs, including tricyclic antidepressants and Scopolamine.Andrade 2019, Dawson 2016, Malamed 2018, Pakala 2019

Animal and in vitro data

Physostigmine-loaded liposomes have been evaluated in vitro and in pharmacokinetic studies in rats to determine the feasibility of prolonging the physostigmine half-life in order to extend protection against the effects of nerve gas exposure that lead to nerve-agent poisoning. The liposomes aided in maintaining constant plasma concentrations of physostigmine.Park 2018

Dementia

Clinical data

Physostigmine from the calabar bean has been investigated for its ability to increase cognition, particularly in patients with Alzheimer disease, but with minimal success.Howes 2011, Howes 2012

Calabar Bean side effects

There are few reports regarding adverse Reactions; calabar bean is toxic to humans, with cases of acute toxicity reported. A study of Wistar rats given P. venenosum extract ranging from 10 to 30 mg/kg/day for 2 weeks displayed signs of hepatic injury.Aihiokhai 2019 CNS effects of physostigmine, which include ataxia and convulsions, can eventually lead to coma.Andrade 2019 Other observed severe adverse reactions include tachycardia and tachyarrhythmia.Pinder 2019 More severe adverse reactions are typically due to overdose. Less severe adverse reactions include GI disturbances, dyspnea, miosis, sweating, hypertension, salivation, headache, and lacrimation.Andrade 2019, Dawson 2016, Effenberger-Neidnicht 2018, Malamed 2018, Pinheiro 2018

Before taking Calabar Bean

Avoid use. Adverse effects have been documented.Ernst 2002

How to use Calabar Bean

Calabar bean's constituent physostigmine has been widely studied as the pure alkaloid available as an approved medication. Clinical data relating to the crude plant material or to an extract are lacking; the bean is toxic and should not be used or ingested.Duke 2002

Warnings

Physostigmine is extremely toxic, with an oral median lethal dose of 4.5 mg/kg in mice. Physostigmine affects heart contractility and induces respiratory paralysis, which can result in death; 2 to 3 beans are sufficient to be lethal.Duke 2002 Based on hepatic injury demonstrated in rats, a P. venenosum extract dose of 20 mg/kg/day should not be exceeded over an extended period of time.Aihiokhai 2019 In the event of physostigmine toxicity, atropine or oximes (eg, pralidoxime) are utilized as antidotes.Andrade 2019, Pakala 2019 Excessive administration of physostigmine can lead to cholinergic toxicity and should be used with caution. Signs of cholinergic toxicity include hypersecretion, salivation, lacrimation, bronchospasm, bradycardia, nausea, vomiting, diarrhea, neuromuscular weakness, coma, and seizures.Dawson 2016, Pakala 2019

What other drugs will affect Calabar Bean

None well documented.

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