Levant Berry

Scientific Name(s): Anamirta cocculus Wight & Arn.
Common Name(s): Cocculus fructus, Cocculus indicus, Fish killer, Fishberry, Hockle elderberry, Indian berry, Kockel-lian, Levant berry, Levantnut, Louseberry, Poisonberry, Tuba biji

Medically reviewed by Drugs.com. Last updated on Sep 21, 2021.

Clinical Overview

Use

Levant berry has traditionally been used to relieve malaria, treat lice, stun or kill fish and game, and manage epilepsy. Clinical use of levant berry has largely been abandoned in the United States and Europe because there are no studies supporting its use. The constituent picrotoxin has been evaluated in limited clinical studies for vertigo.

Dosing

No clinical evidence supports any clinical applications of levant berry. In a small clinical study, picrotoxin suppositories (1 mg 3 times per week) were more effective than betahistine in reducing the frequency and intensity of vertigo attacks.

Contraindications

Toxicity of the constituent picrotoxin has been established.

Pregnancy/Lactation

Avoid use. Adverse effects have been documented.

Interactions

None well documented.

Adverse Reactions

Picrotoxin stimulates the CNS and is a GI irritant.

Toxicology

High doses can cause salivation, vomiting, purging, rapid shallow respiration, palpitations or heart slowing, stupor, loss of consciousness, and death. Death from doses of 2 to 3 g of the fruit has been reported.

Scientific Family

• Menispermaceae (moonseed)

Botany

A. cocculus, known as levant berry, is a climbing woody shrub native to India, Burma, and other parts of Malaysia. It has wide thick leaves and rootlets that ooze a white milky latex. The fragrant flowers produce U-shaped seeds. The fruit dries to a bitter, nearly black wrinkled shape.Duke 2002, Morton 1977, USDA 2015

History

The fruit of levant berry is gathered from the wild and sun dried for export. In India, the leaves have been inhaled as a snuff to relieve malaria, and the leaf juice used in combination with other natural products as a vermifuge.Morton 1977 Extracts of the plant have been applied topically for lice, but the toxic nature of the components (in particular picrotoxin) makes this application dangerous, especially in cases of abraded or irritated skin. For centuries, fishermen in Asia used the seeds to produce a poison to stun fish,Bause 2013 and in some societies, ground whole dried fruit has been used to kill birds or dogs, and to stupefy game as well as fish.Jablonski 2008 Picrotoxin has been used as a stimulant for the management of morphine and barbiturate poisoning and was considered an official remedy for epilepsy at the turn of the 19^th century into the 20^th in the United States; however, it is no longer used for this condition because of severe toxicity.Duke 2002, Morton 1977 Use as a biological weapon has been suggested for picrotoxin because of the ease of chemical isolation and purification.Jablonski 2008

Chemistry

The fruit flesh and seed shells contain the nontoxic alkaloids menispermine and paramenispermine.Morton 1977, Verpoorte 1981 The seed, however, contains the bitter, toxic principle picrotoxin (1.5% to 5%); this compound can be separated into picrotoxinin and picrotin, which are oxygenated sesquiterpene derivatives.Duke 1992 The tasteless compounds anamirtin and cocculin are also present, along wi...