1) Structure1

IUPAC name : strynidin-10-one

Strychnine is a white and odorless, crystalline compound with an extremely bitter taste.

2) Source The source of the strychnine toxin comes from the seeds of the Strychnos nux vomica plant (shown below2). This plant can be found in Australia and Southern Asia and its seeds contain approximately 1.5% of the strychnine toxin 6. More commonly, Strychnine is found in rodenticides used to kill rats. At one time Strychnine was used therapeutically in laxatives and stimulant tonics but has since been shown to have no quality therapeutic advantage7. According to the CDC, another interesting and very rare use for Strychnine is its mixture with street drugs.

3) Common Routes of Exposure Strychnine can be inhaled, ingested, or absorbed through the eyes and skin. Strychnine is readily absorbed in the GI tract and easily metabolized by liver microsomes. Approximately 20% of the original toxin is excreted unchanged in the urine8.

4) Signs and Symptoms Strychnine poisoning is very serious because only a small amount can be lethal in humans. Fatal doses of Strychnine have been reported as low as 5-10 mg11 however one adult survived after ingesting 3750 mg. The main symptom of strychnine poisoning is involuntary convulsions. The convulsions have been described as starting out with intermittent movements that last a short time before a rigid , stiff position takes over13. This stiff position includes the arching of the back with arms and legs rigidly bent or extended. The jaw is clamped shut and hands are locked into fists. The face is often frozen in a sort of grimace and eyes are open but fixed in a stare. The convulsions can be caused by outside stimulus such as visual or auditory stimuli. In addition, during the convulsion respiration stops which is the main cause of death from strychnine poisoning. Patients who die usually die from suffocation. Patients can also die from organ failure caused by extreme acidosis9. Acidosis is caused by the large build-up of lactic acid due to the constant muscle tension. In between the convulsions there are periods in which patients are totally relaxed with a cold sweat. During the convulsion episodes, the patient is fully conscience. The periods of convulsion and relaxation may continue until recovery or death. In addition to the convulsions other symptoms include heightened perception, anxiety, restlessness, and muscle stiffness primarily in the face and legs.

5) Treatment Strychnine poisoning is treatable if the patient is presented early after exposure. Initial treatment often involves the administration of activated charcoal to remove Strychnine from the GI tract that has not yet been absorbed. If the patient is experiencing severe convulsions then diazepam (shown below3)or phenobarbitol are usually administered to relax the muscles and stop the convulsions12. If a patient is not responding to the diazepam then pancuronium may be administered as a neuromuscular blockader to induce paralysis. Also, it is important to keep the patient away from outside stimulus as it may cause more convulsions.

6) Mode of Action Strychnine is a competitive antagonist to glycine10. Glycine is a neurotransmitter in the central nervous system. Glycine has receptors in the brain stem that work to slow signals coming into and out of the brain. Since Strychnine is an antagonist, it causes more rapid signals into and out of the brain. Since the signals are not being slowed down, they are sent without discrimination which causes over stimulation. As a result, severe muscle convulsions are seen.

7) Strychnine Doping In low dosages, Strychnine can act as a stimulant and has been used by athletes to enhance their performance. Strychnine made headlines back in 1904 during the St. Louis Olympics. At this time there were no rules about the use of performance enhancing drugs. An American man by the name of Fred Lorz won the marathon competition but was disqualified just after crossing the finish line because officials learned he had taken a car ride for part of the race. The next man to finish was from Britain and his name was Thomas Hicks. Hicks won the gold medal but not without a little help. About 10 miles from the finish line Hicks begged his trainers to let him stop running and give-up the race. His trainers refused and gave him a dose of strychnine as a stimulant to keep him going14. They also gave him raw egg-white and brandy. As a result Hicks had to be carried across the finish line (shown below4) and it took four doctors to revive him so that he could leave the stadium. This was only one of the many controversial events of the 1904 Olympics.

More recently at the 1992 Barcelona Olympics, Strychnine was used to optimize the athletic performance of a female volleyball player from China15. The woman's name was Wu Dan and she was actually the first person to test positive for drugs at the olympics. She tested positive for Strychnine that she claims she did not know she was taking. The Strychnine was contained in capsules that Dan was taking without the knowledge of the team doctor. She took the capsule as a tonic because she was feeling a bit tired. The Olympic committee banned her from any more competition but stated that Dan did not intentionally cheat but the mistake was due to poor education.

8) Murder by Strychnine A doctor by the name of William Palmer (shown below 5) was convicted and hanged to death for the murder of John Parsons Cook. Palmer was accused of poisoning Cook with Strychnine. He denied that he had any involvment with Cook's death but was ultimately found guilty. In addition to the death of Cook it is believed that Palmer was responsible for fifteen other deaths, all by Strychnine poisoning. Some of his other victims were believed to be his wife and four of his children. Palmer was nicknamed the 'Prince of Poisoners'.