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Betel nut

The betel nut palm, also known as the areca palm, is a plant whose nuts are used to make medicine. Betel nuts are chewed as whole nuts or in the form of chewing tobacco made from a mixture of tobacco, ground betel nuts and hydrated lime. Betel nuts are used to treat schizophrenia and glaucoma, as a mild stimulant and to aid digestion. Some people use areca nuts as a party drug as they stimulate the central nervous system. In veterinary medicine, an areca extract is used to treat tapeworms in cattle, dogs and horses, to empty the intestines and to treat colic in horses.

How do betel nuts work?

Betel nut is believed to affect chemicals in the brain and other areas of the central nervous system

How effective are betel nuts?

There is not enough scientific data to make a statement about the effectiveness of areca nuts for the treatment of schizophrenia. Some research suggests that betel nut may be helpful in schizophrenia. Some patients suffering from schizophrenia who chew areca nuts appear to have less severe symptoms. There is also insufficient scientific data on the effectiveness of betel nut in glaucoma and as a digestive aid. Further scientific research is needed to evaluate the effectiveness of areca nuts in these applications.

Are there any safety concerns?

Not enough is known about the safety of short-term oral ingestion of areca nut. However, areca nuts are not considered safe and harmless when used over a long period of time or in high doses. Some of the chemicals found in betel nuts have been linked to cancer. Other chemicals found in betel nuts are toxic. Eating 8 to 30 grams of betel nuts can be fatal. Chewing areca nuts can cause red discoloration of the mouth, lips and stool. Areca nuts have a stimulating effect similar to that of caffeine and tobacco. Possible side effects include vomiting, diarrhea, gum problems, increased saliva production, coma and death.

Precautions and warnings

Pregnancy and lactation: Oral ingestion of areca nut is not safe for anyone due to cancer and toxicity concerns. However, there are additional risks for pregnant and breastfeeding women. Betel nuts can affect the central nervous system and this can jeopardize pregnancy. Chemicals contained in betel nuts could pass into breast milk and harm breastfed babies. For these reasons, pregnant and breastfeeding women should avoid betel nut to be on the safe side.

Asthma: Betel nut can aggravate asthma.

Interactions with medication

Care should be taken when combining areca nut with the following medications:

Desiccant medications (anticholinergic agents)

Areca nuts contain chemicals that affect the brain and heart. Desiccating drugs, also known as anticholinergic drugs, can have the same effect. However, arecanuts work in a different way to these drugs. Arecanuts can reduce the effect of these drugs.

Procyclidine

Procyclidine can affect certain chemicals in the body. Betel nuts can also affect certain chemicals in the body, but arecanuts have the opposite effect of procyclidine. Taking areca nuts in combination with procyclidine could therefore reduce the effectiveness of procyclidine.

Certain drugs used to treat glaucoma, Alzheimer's and other diseases (cholinergic drugs)

Betel nuts contain a chemical that has certain effects in the body. This chemical is similar to the active ingredients in some drugs used to treat glaucoma, Alzheimer's and other diseases. Taking betel nut in combination with these medications could increase the risk of side effects.

Dosage

An appropriate dosage of areca nut depends on several factors such as age and health status of the user. There is not yet sufficient scientific information to determine an appropriate dosage for areca nut. For this reason, you should follow the dosage instructions on the label or consult a doctor or pharmacist.

References

  1. Cox SC, Walker DM. Oral submucous fibrosis. A review. Aust Dent J 1996;41:294-9.
  2. Gupta PC, Sinor PN, Bhonsle RB, et al. Oral submucous fibrosis in India: a new epidemic? Natl Med J India 1998;11:113-6.
  3. Sullivan RJ, Allen JS, Otto C, et al. Effects of chewing betel nut (Areca catechu) on the symptoms of people with schizophrenia in Palau, Micronesia. Br J Psychiatry 2000;177:174-8.
  4. Trivedy C, Warnakulasuriya S, Peters TJ. Areca nuts can have deleterious effects. BMJ 1999;318:1287.
  5. VanWyk CW. Oral submucous fibrosis. The South African experience. Indian J Dent Res 1997;8:39-45.