S.J. Orndorff, (They/Them), is a non-binary freelance writer who adores plants, plant-derived medicines, herbal medicine, and botany.
My fascination with scopolamine started in December of 2021 when I went into the hospital for out-patient surgery. As the nurses prepared me, I mentioned that I got anesthesia sickness post-surgery. They told me that I would have a scopolamine patch and a few minutes later, a small patch, smaller than a dime, was placed behind my ear.
I already knew a little bit about scopolamine and that it was related to belladonna in the Solanaceae family. My experience with scopolamine as a medicine prompted my enthusiastic curiosity. Who discovered the first plants that scopolamine came from? What was its history? How and why did it come to be used as a medicine? How does it work? As I dived into Scopolamine's world, an intriguing timeline began to emerge of the doctors, botanists, and chemists who brought scopolamine into modern-day use and made it one of the most important medicines today.
Scopolamine's story begins, in earnest, with physician and naturalist Giovanni Antonio Scopoli. In 1750, Scopoli was sent to quicksilver mines in Carniola by the Austrian government to study the effect of mercury on the miners. While there, Scopoli often wandered the mountains of Carniola, cataloging 1500 specimens during his stay, including the humble, shrubby plant that he would come to name Flora carniolica. These specimens, along with Flora carniolica, were published in 1760. Four years later, Vienna botanist, Nikolaus Joseph von Jacquin, renamed Flora carniolica to Scopola carniolica in honor of Scopoli for his unique find.
Pharmacologists began studying Scopola carniolica and plants with similar properties towards the end of the 19th century. This led German scientist, Ernest A. Schmidt, (1845–1921), at the University of Marburg, to discover what would become an important phytochemical of Scopola carniolica. From its dried taproot, Schmidt discovered what would later become known as a tropane alkaloid and named it Scopolamine.
Renowned German chemist, Albert Ladenburg, (1842-1911), continued to study scopolamine and eventually isolated it for modern-day use in 1880. 1875 saw atropine, a similar alkaloid to scopolamine synthetically reproduced for the first time by Ladenburg. He won the prestigious Davy medal for the synthesis of natural alkaloids in 1905 and paved the way for scopolamine to be fully synthesized in 1959. However, artificially synthesized forms of scopolamine are currently still not as effective as extracting it from the plants that produce it.
Scopolamine's botanical origins have its roots in the solanaceae family, also commonly known as nightshades. Other scopolamine producing plants in this family include belladonna, (Atropa belladonna), henbane, (Hyoscyamus niger), jimson weed, (Datura stromonium) and angel's trumpet, (Brugamansia suaveolens). These deadly, poisonous plants also share the solanaceae family with the delicious and edible tomato, potato and eggplant.
The solanaceae family has about 2,500 species and 102 genera. Only roughly fifty species are found in the United States and Canada. The bulk of the solanaceae family's species are found in hotter, more tropical zones and very few are found in temperate regions. Almost half of all species are in the solanum genus and only about then of the genera produce scopolamine, including the well-known Atropa, Brugamansia, Hyocyamus, and, of course, Scopolia.
Characteristically, solanaceae plants can be annual, perennial or biennial. The leaves are typically simple and grow alternately. Flowers often come in a star or flat, round shape that present themselves singularly or in clusters. However, a bell or tubular shape flower is more commonly found. They have five sepals, petals, stamen and a superior ovary that sits above the other flower parts.
Nightshade stems tend to be herbaceous and weak, as well as prickly or hairy. Their roots are a rhizome, or tap root, system, as in potatoes. They are also fruit-bearing plants that produce berries, as in tomatoes. As in most plants, the production of bitter, nitrogen-containing compounds known as alkaloids, help the plant defend itself from herbivores and disease. There are about 5,000 known alkaloids, of which scopolamine is only one, and they can be found in plant sources as well as animals.
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Uses in Modern Medicine
Scopolamine is a tropane alkaloid similar in use and chemical structure to atropine found in belladonna. The first uses of Scopolamine as medicine started in the 1900s as anesthesia. Perhaps the most famous of early uses is that of Dӓmmerschlaf, pioneered by a German doctor, Karl Gauss in 1903.
Dӓmmerschlaf, otherwise known as “twilight sleep”, was a state induced in birthing mothers by combining scopolamine and morphine. It was anesthetic, pain-relieving and often, the mother would not remember giving birth, due to the amnestic properties of scopolamine. This combination was used, at the time, as what was thought to be a safer alternative to chloroform. The practice of inducing twilight sleep was discontinued in the 1960s over rising concerns of serious complications that resulted in prolonged labor and severe depression of the nervous system, leading to suffocation and death, especially in the infant.
In 1947, scopolamine was regularly being used as an antiemetic for motion sickness and postoperative nausea and vomiting, (PONV). It wasn't until the 1970's that it was officially approved by the FDA for this use. Scopolamine's main uses today continue to be for motion sickness and PONV. It is generally administered by a small, transdermal patch placed behind the ear. Off-label, scopolamine may also be used to treat gastrointestinal spasms, muscle spasms, Parkinson's-like symptoms, asthma attacks, or used as smoking cessation therapy.
Interestingly, Scopolamine does not stop nausea or vomiting already in progress. It must be administered well before exposure to anesthesia or a situation involving motion, such as a car ride. Scopolamine in transdermal patch form is slow to act (the onset is about four hours), but can be worn up to three days, delivering a total of 1 mg of medication over that period of time.
The three main mechanisms of Scopolamine are anticholinergic, antiemetic, and antispasmodic. The anticholinergic effect blocks the neurotransmitter acetylcholine in the medulla oblongata, the part of the brain responsible for vomiting. Its H1 receptors are susceptible to the effects of scopolamine, therefore, decreasing nerve signals from the brain that trigger the stomach to vomit. As anti-spasmodic, blocking acetylcholine also reduces involuntary muscle movement. Scopolamine includes amnestic, (causing amnesia/memory loss), and sedative effects as well.
Scopolamine, also known as hyoscine, should not be confused with hyoscyamine. Hyoscyamine, also called daturine, is derived from henbane, (Hyocyamus niger). From the perspective of chemical structure, Scopolamine has the chemical structure of C-17, H-21, NO4, while Hyoscyamine has the chemical structure of C-17, H-23, NO3. These two tropane alkaloids are very similar, but they work somewhat differently.
Hyoscine/scopolamine tends to be more powerful in general, and a stronger central nervous system depressant, as well as amnestic. It is selective about which receptors it blocks and can be extremely toxic in very minute doses. Hyoscyamine/daturine tends to block all cholinergic receptors. Generally, it takes a much higher dose of hyoscyamine before it becomes toxic, and central nervous system depression can take longer, compared to hyoscine/scopolamine.
Scopolamine remains an important, primary medication for the clinical management for motion sickness, PONV, and other conditions. Its discovery opened the doors for looking at how plant-based alkaloids function, how they were synthesized, particularly for medicinal use, and which botanical family harbored the most scopolamine producing plants, gifting us with similarly powerful medicines. Scopolamine's fascinating history, botanical origins, and uses will continue to intrigue doctors, botanists, pharmacologists, and the generally curious for years to come.
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This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
© 2022 SJ Orndorff