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CASE STUDY
Year : 2015  |  Volume : 36  |  Issue : 2  |  Page : 174-176  

Adverse reaction of Parasika Yavani (Hyoscyamus niger Linn): Two case study reports


1 One World Ayurveda, Bali, Republic of Indonesia
2 Chair of Ayurveda, Universitas Hindu Indonesia (UNHI), Denpasar, Bali, Republic of Indonesia
3 Department of Basic Principles, Institute for Post Graduate Teaching and Research in Ayurveda, Gujarat Ayurved University Jamnagar, Gujarat, India

Date of Web Publication3-Feb-2016

Correspondence Address:
Dr. K Aparna
Consulting Physician, Purnayoo Arogya Nikethanam, Ayurveda and Yoga Research Centre, Meenangadi - 673 591, Kerala, India

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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-8520.175550

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   Abstract 

Adverse drug reaction (ADR) is an unpleasant reaction related to the use of medicine at its therapeutic dose. Ayurveda is well aware of such adverse reactions. Parasika Yavani (Hyoscyamus niger Linn.) is an Ayurvedic drug effectively used in many psychological disorders, if not used judiciously it causes adverse reactions. In present study two cases of ADR on the usage of Parasika Yavani are reported. Churna in capsule form given in different dosage forms (500 mg once a day, 250 mg twice a day, 250 mg once a day) in Chittodwega (generalised anxiety disorder). 500mg capsule was given to many patients in the study, but no adverse reactions were noticed except in above given two cases. So, in these two cases, the dose was tapered down to 250 mg twice a day, and then to 250 mg once a day to avert the adverse reactions and to fix the therapeutic dose in such individuals (250 mg once a day). On analysis, these two individuals were found to be of Pitta Prakriti. Parasika Yavani is found to increase Pitta and triggers the establishment of ADRs. So, while administering therapeutic dosage, a physician should be vigilant. In the current study, it is observed that 500 mg of Parasika Yavani powder in Pitta Prakriti individuals triggered ADRs while 250 mg once a day was safe. It was also observed that Kapha and Vata Prakriti, patients did not develop any adverse reactions.

Keywords: Adverse drug reaction, Ayurvedic drug, Parasika Yavani, Pitta Prakriti, therapeutic dose


How to cite this article:
Aparna K, Joshi AJ, Vyas M. Adverse reaction of Parasika Yavani (Hyoscyamus niger Linn): Two case study reports. AYU 2015;36:174-6

How to cite this URL:
Aparna K, Joshi AJ, Vyas M. Adverse reaction of Parasika Yavani (Hyoscyamus niger Linn): Two case study reports. AYU [serial online] 2015 [cited 2020 Apr 5];36:174-6. Available from: http://www.ayujournal.org/text.asp?2015/36/2/174/175550


   Introduction Top


Ayurveda offers a system of natural healing that is very complete both in terms of its treatment and also in its understanding of the human being. It offers a vision of healing for curing disease, for preventive health, and ultimately for spiritual liberation.[1] Since ages, Ayurveda is being practiced in India. Now in this era of globalization, certain concerns are being raised with regards to the safety of plants or plant based products. Adverse reactions of many Ayurvedic medicines are yet to be reported. Ayurveda has categorized toxic plants separately and for their use, special processing is essential.[2] If not processed properly and not used judiciously, these drugs may prove to be fatal. It is the need of the hour to report all such adverse drug reactions (ADRs) associated with administration of Ayurvedic drugs.

An ADR can be termed as “an appreciably harmful or unpleasant reaction, resulting from an intervention related to the use of a medicinal product, which predicts hazard from future administration, and warrants prevention or specific treatment, or alteration of the dosage regimen, or withdrawal of the product.”[3] ADRs are classified into six types: Dose-related (augmented), dose-related (bizarre), dose-related and time-related (chronic), time-related (delayed), withdrawal (end of use), and failure of therapy (failure). Timing, the pattern of illness, the results of investigations, and rechallenge can help attribute causality to a suspected ADR. Management includes withdrawal of the drug, if possible and specific treatment of its effect.[3] Few such adverse reactions are observed while administering the single drug Parasika Yavani (Hyoscyamus niger Linn.).

Parasika Yavani commonly known as Henbane is considered as a Madaka Dravya (narcotic) by Bhavaprakasa.[4] It is useful in conditions such as Unmada (psychological disorders), Anidra (insomnia), etc.[5] In the present study, Parasika Yavani Beeja Churna (seed powder) was given in the treatment of Chittodwega (anxiety).


   Case Reports Top


Case 1

A 30-year-old male patient, a normotensive and nondiabetic of Pitta predominance was diagnosed as a case of generalized anxiety disorder. The patient was administered with 500 mg Parasika Yavani seed powder once daily in June 2013 as a part of study conducted at IPGT and RA, Jamnagar. After two days, the patient presented with severe headache, blurred vision, burning sensation in eyes, and hot flushes. Patient was asked to withdraw the medicine for two days. By the second day, the symptoms were found to be relieved. The medicine was restarted on the third day and similar symptoms were again manifested. Medicine was again withdrawn and after 1-week 250 mg of the same medicine was given twice daily. Patient reported mild headache on taking the medicines, so it was discontinued. After two days, 250 mg once daily was given, and the patient was found to be comfortable with the dose. The patient continued the medicine for the next 28 days without developing any ADR.

Case 2

A 37-year-old male patient of Pitta Prakruti was treated for generalized anxiety disorder with 500 mg of Parasika Yavani seed powder once daily in as a part of study conducted at IPGT and RA, Jamnagar. On second day, the patient presented with severe headache, blurred vision, and pain in the eyes. Medicine was discontinued. Three days later, the patient was given 250 mg of same powder twice daily. Patient reported again similar symptoms on the third day. Medicine was stopped, and 250 mg once daily was started after a week. The patient did not complain any adverse reactions on this dose and continued it for a month.


   Discussion Top


Parasika Yavani seeds are Katu (bitter), acrid, Madaka (narcotic), Vedanasthapaka (analgesic), Krimighna (antihelminthic), Sulaprashamana (antispasmodic), Nidrajanaka (induces sleep), anti-inflammatory, and expectorant.[6] They are useful in Unmada (psychological disorders), Anidra (insomnia), Pralapa (restlessness), odontalgia, bleeding gums, dental caries, orchitis, rheumatoid arthritis, dyspepsia, worm infestation, cardiac debility, flatulence, colic, asthma, bronchitis, neuritis, fever, meningitis, amenorrhea, urinary tract infection, and irritability.[5],[7] It contains tropane alkaloids called, hyoscine (scopolamine), hyoscyamine (L-atropine), and atropine (DL-hyoscyamine).[6] In higher dose, it causes dry mouth, thirst, difficulty in swallowing, and speaking, warm flushed skin, dilated pupils, blurred vision, and photophobia, vomiting, urinary retention, tachycardia, pyrexia, drowsiness, slurred speech, hyper-reflexia, auditory, visual, or tactile hallucinations, confusion, disorientation, delirium, agitation, and combative behavior. In severe cases, there may be hypertension, coma, and convulsions.[6],[8]

The dosage of seed powder given in different Ayurvedic and modern texts vary from 125 mg to 3 g.[5] In above reported cases, the dosage given was within the advised therapeutic dosage limit. 500mg capsule were given to many patients, but no adverse reactions were noticed except in above given two cases. So, the dose was tapered down to avert the adverse reactions and to fix the therapeutic dose. The reactions observed in the current study can be categorized under type A/dose-related ADR. On analysis, these two individuals were found to be of Pitta Prakriti. Parasika Yavani is found to increase Pitta.[6] Possibly, the drug aggravates Pitta in such individuals and triggers the establishment of ADRs. It was also observed in the same research study that the patients belonging to Kapha and Vata Prakriti did not develop any adverse reactions.

The principles of Ayurvedic treatment were established on the basis of “Purusham Purusham Veekshya” that is, each patient is unique, and different.[9] Ancient texts were very well aware of the toxicity and provided guidelines to avoid such manifestations. Prakriti of the patient plays a very important role in the drug administration, and metabolism. So while administering therapeutic dosage, physician should be vigilant.


   Conclusion Top


In the current study, it is observed that 500 mg of Parasika Yavani powder in Pitta Prakriti individuals triggered ADRs. It was also observed that Kapha and Vata Prakriti patients did not develop any adverse reactions. And as per observations from study 250 mg once daily is found to be ideal in Pitta Prakriti.

Financial support and sponsorship

IPGT and RA, Gujarat Ayurved University, Jamnagar, Gujarat, India.

Conflicts of interest

There are no conflicts of interest.

 
   References Top

1.
Acharya JT, editor. Charaka Samhita of Agnivesha, Sutra Sthana, Ch. 1, Ver. 43. 11th ed. Varanasi: Chaukhamba Sanskrit Bhavan; 2011. p. 22.  Back to cited text no. 1
    
2.
Anonymus. National Pharmacovigilance Protocol for ASU Drugs. Jamnagar: National Pharmacovigilance Resource Centre, Institute for Post Graduate Teaching and Research in Ayurveda, Gujarat Ayurved University; 2008. p. 23.  Back to cited text no. 2
    
3.
Edwards IR, Aronson JK. Adverse drug reactions: Definitions, diagnosis, and management. Lancet 2000;356:1255-9.  Back to cited text no. 3
    
4.
Chunekar KC, editor. Bhavaprakasha Nighantu of Bhavamishra, Haritakyadi Varga, Ver. 80, 2nd ed., Vol. 1. Varanasi: Chaukambaha Prakashan; 2010. p. 29.  Back to cited text no. 4
    
5.
Anonymus. The Ayurvedic Pharmacopia of India. Part-1. 1st ed., Vol. 5. New Delhi: Ministry of Health and Family Welfare, Government of India; 2010.  Back to cited text no. 5
    
6.
Pandey G. Dravya Guna Vijnana. 2nd ed., Vol. 3. Varanasi: Chowkamba Krishnadas Academy; 2004.  Back to cited text no. 6
    
7.
Sharma PC, Yelne MB, Dennis TJ. Database on Medicinal Plant. Vol. 7. New Delhi: CCRAS, Ministry of Health and Family Welfare, Department of AYUSH, Government of India; 2005.  Back to cited text no. 7
    
8.
Available from: http://www.thepoisongarden.co.uk. [Last accessed on 2008 Dec 12].  Back to cited text no. 8
    
9.
Acharya JT, editor. Charaka Samhita of Agnivesha, Sutra Sthana, Ch. 1, Ver. 123. 11th ed. Varanasi: Chaukhamba Sanskrit Bhavan; 2010. p. 28.  Back to cited text no. 9
    



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