Also Known As: Belladonna, Atropa belladonna, Devil's Berries, Death Cherries, Deadly Nightshade

Atropa belladonna or Atropa bella-donna, commonly known as Belladonna, Devil's Berries, Death Cherries or Deadly Nightshade, is a perennial herbaceous plant in the family Solanaceae, native to Europe, North Africa, and Western Asia. The foliage and berries are extremely toxic, containing tropane alkaloids. These toxins include scopolamine and hyoscyamine which cause a bizarre delirium and hallucinations,[1] and are also used as pharmaceutical anticholinergics. The drug atropine is derived from the plant.

It has a long history of use as a medicine, cosmetic, and poison. Before the Middle Ages, it was used as an anesthetic for surgery; the ancient Romans used it as a poison (the wife of Emperor Augustus and the wife of Claudius both used it to murder contemporaries); and predating this, it was used to make poison tipped arrows. The genus name "atropa" comes from Atropos, one of the three Fates in Greek mythology, and the name "bella donna" is derived from Italian and means "beautiful woman".

Belladonna tinctures, decoctions, and powders, as well as alkaloid salt mixtures, are produced for pharmaceutical use, and these are often standardised at 1037 parts hyoscyamine to 194 parts atropine and 65 parts scopolamine. The alkaloids are compounded with phenobarbital and/or kaolin and pectin for use in various functional gastrointestinal disorders. The tincture, used for identical purposes, remains in most pharmacopoeias, with a similar tincture of Datura stramonium having been in the US Pharmacopoeia at least until the late 1930s. The combination of belladonna and opium, in powder, tincture, or alkaloid form, is particularly useful by mouth or as a suppository for diarrhoea and some forms of visceral pain; it can be made by a compounding pharmacist, and may be available as a manufactured fixed combination product in some countries (e.g., B&O Supprettes). A banana-flavoured liquid (most common trade name: Donnagel PG) was available until 31 December 1992 in the United States.

Scopolamine is used as the hydrobromide salt for GI complaints, motion sickness, and to potentiate the analgesic and anxiolytic effects of opioid analgesics. It was formerly used in a painkiller called "twilight sleep" in childbirth.[28]

Atropine sulphate is used as a mydriatic and cycloplegic for eye examinations. It is also used as an antidote to organophosphate and carbamate poisoning, and is loaded in an autoinjector for use in case of a nerve gas attack. Atropinisation (administration of a sufficient dose to block nerve gas effects) results in 100 per cent blockade of the muscarinic acetylcholine receptors and atropine sulphate is the benchmark for measuring the power of anticholinergic drugs.

Hyoscyamine is used as the sulphate or hydrobromide for GI problems and Parkinson's disease. Its side effect profile is intermediate to those of atropine and scopolamine, and can also be used to combat the toxic effects of organophosphates.

Scientific evidence to recommend the use of A. belladonna in its natural form for any condition is insuffiicient,[17] although some of its components, in particular l-atropine which was purified from belladona in the 1830s, have accepted medical uses.[20] Donnatal is a prescription pharmaceutical, approved in the United States by the FDA, that combines natural belladonna alkaloids in a specific, fixed ratio with phenobarbital to provide peripheral anticholinergic/antispasmodic action and mild sedation. According to its labeling, it is possibly effective for use as adjunctive therapy in the treatment of irritable bowel syndrome (irritable colon, spastic colon, mucous colitis) and acute enterocolitis.[29]

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