How dangerous is nutmeg?

Summary This literature review aimed to evaluate the potential severity of nutmeg poisoning. Articles included were English, Danish, Norwegian or Swedish-language articles published between 1990 and 2025 that described unique cases of poisonings. Only articles with nutmeg as the primary toxic agent that led to contact with the healthcare system were included. The articles were identified through searches in PubMed and Embase on 14 April 2025. One reviewer screened the articles, and included articles were retrieved for manual data extraction. The final sample included 14 case reports and 4 case series, encompassing a total of 179 unique cases. The findings indicate that nutmeg poisoning can be potentially harmful. The most frequently reported adverse effects were psychotic symptoms (18%), vomiting (14%), and abdominal pain (13%). Other commonly reported symptoms included tachycardia (25%), nausea (13%), and agitation (12%). While no deaths were reported, several severe adverse effects such as impaired consciousness and polydipsia could pose significant health risks without appropriate treatment. The overall level of evidence is limited, as case reports and case series inherently carry a high risk of bias and low generalizability. Milder cases are likely underreported, while more severe or unusual cases are overrepresented. Additionally, there was considerable variability in reporting of symptoms, and many studies lacked clear documentation of patient history and ingested dosage.