Work

Conservative management of mad honey poisoning presenting with bradycardia: a case report

Year: 2026

Type: article

Abstract: BACKGROUND: Mad honey is a type of honey with hallucinogenic properties found in the Himalayas of Nepal. It is used by locals for its supposedly medical and recreational properties. It contains a toxin named 'Grayanotoxin' which is mainly derived from the nectar of few Rhododendron species native to Himalayas. CASE PRESENTATION: This is a case report of 38-year-old male who presented to emergency department of our center with dizziness, three hours following ingestion of mad honey. He had heart rate of 45 beats per minute. Electrocardiogram showed bradycardia without any other abnormality. He was managed conservatively in coronary care unit for 48 h without any complication. CLINICAL DISCUSSION: "Grayanotoxin" is a neurotoxin that acts on voltage-gated sodium channels, preventing their inactivation and causing persistent depolarization, leading to a wide range of symptoms. Management is symptomatic as no antidotes are available till date. Early recognition prevents unnecessary investigations and interventions. CONCLUSION: Mad honey poisoning should always be considered in patient particularly those living in endemic areas presenting with unexplained dizziness and bradycardia. Most of these cases respond well to supportive therapy emphasizing the importance of early recognition and close clinical observation.

Source: Journal of Medical Case Reports

DOI: 10.1186/s13256-026-06292-5

Authors: Sushan Ghimire, Salina Subedi, Navaraj Paudel

Institution: Manipal College of Medical Sciences

Language: English

Topic: Plant-based Medicinal Research

Subfield: Pharmacology

Field: Pharmacology, Toxicology and Pharmaceutics

Domain: Life Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,890