For those of you who remember Super Mario Bros… how awesome was it to gobble up that red and white mushroom gliding along the ground and get huge for a few seconds? The result of consuming this mushroom was a bigger and badder Super Mario who was ready to break bricks and take names. However, the color and effects of the mushroom in the game were not chosen at random.

 

This Nintendo mushroom is based on a real mushroom called Amanita Muscaria. You can probably see the resemblance:

This mushroom has been ingested for thousands of years due to its sensory alteration abilities, and is still sometimes used today. The CNS effects of Amanita Muscaria are largely due to 2 compounds. The first is called muscimol, which is structurally similar to GABA causing CNS depression. The other is ibotenic acid, which has agonist effects at glutamic acid receptors causing an excitatory CNS response. The combination of these chemicals produces a distinctive syndrome alternating between drowsiness and agitation with hallucinations. Seizures, GI symptoms, dizziness, and LOC have also been reported, with effects lasting from a few hours to several days.

 

Death from this species of mushroom is highly unlikely and the treatment is largely supportive. Activated charcoal should be strongly considered, but unlike some other species of mushrooms Amanita muscaria does not contain large amounts of muscarine, and true cholinergic excess is unlikely. Benzodiazepines are helpful for seizures and agitation, and IV fluids +/- Zofran help alleviate GI symptoms.

 

Sources:

 

Wiegand, TJ. Management of mushroom poisoning. In: UpToDate, Wiley, JF (Ed), UpToDate, Waltham, MA, 2018.

Benjamin DR. Mushroom poisoning in infants and children: the Amanita pantherina/muscaria group. J Toxicol Clin Toxicol. 1992;30(1):13-22.

Satora L et al. Fly agaric (Amanita muscaria) poisoning, case report and review. Toxicon. 2005 Jun 1;45(7):941-3. Epub 2005 Apr 14.

Mushroom. Digital Image. Wikipedia. 21 March 2019. https://en.wikipedia.org/wiki/Mushroom

Super Mario Bros Super Mushrooms. Digital Image. UberFacts. 30 August 2013. https://twitter.com/uberfacts/status/373494605989568512

 

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