An Atypical Case Report - Strychnos nux-vomica toxicity resulting from Vishtinduk Vati overdose linked with bradycardia

Strychnos nux-vomica, commonly known as poison nut, is a plant notorious for its toxic alkaloids, particularly strychnine and brucine. While cases of poisoning from nux-vomica ingestion have been documented, its occurrence following Vishtinduk Vati overdose is exceedingly rare. Here a case of a 55-year-old female with a known history of osteoarthritis who inadvertently overdosed on Vishtinduk Vati, an over-the-counter Ayurvedic medicine containing nux-vomica, in an attempt to alleviate her pain, led to severe poisoning characterized by classical symptoms of strychnine toxicity, including muscle twitching, vomiting and bradycardia, necessitating immediate medical intervention. This case highlights the dangers of self-medication with herbal remedies and the accessibility of potentially harmful over-the-counter Ayurvedic medications. It underscores the importance of healthcare providers opting for safer drug choices in daily practice and advocating against the indiscriminate use of herbal supplements, emphasizing the need for regulation and education to prevent such adverse outcomes.