Group in the POISINDEX classification: II
Mushrooms involved:
(1) Amanita muscaria (bright red or yellow cuticle)
(2) Amanita pantherina (brown cap)
(3) Amanita regalis
(4) Amanita gemmata
Toxins:
(1) muscimol
(2) ibotenic acid (metabolized to muscimol)
(3) muscazol (derivative of muscimol)
Sources of exposure:
(1) smoking dried mushrooms
(2) drinking mushroom tea
(3) eating mushroom soup
(4) swallow small pieces of mushroom
(5) commercial muscimol or ibotenic acid
(6) for the true degenerate, drinking urine of a user (since the toxins are excreted unchanged in the urine)
Onset of symptoms: usually within 60 minutes, occasionally up to 3 hours
Clinical findings:
(1) hallucinations and visual disturbances
(2) delirium
(3) physical hyperactivity with agitation and tremor
(4) euphoria with drunken behavior
(5) ataxia
(6) muscle cramps and fasciculations
(7) seizures
(8) anxiety or depression
(9) difficulty in visual accommodation
(10) drowsiness with deep sleep, stupor or coma
(11) rarely nausea and vomiting
(12) rarely fatal
Acute symptoms can last up to 6-8 hours but depend on the dose of toxin ingested. The person may sleep for 10-15 hours afterwards.
