Areca Nut (Betel Nut)

Last updated 01/02/18

Definition

• Seed of the Areca catechu consumed for its euphoric effects and is associated with dependancy





Betel Nut (Areca Nut)

Features

• Found in tropical Pacific, Asia and parts of Africa
• Popular in South-East Asia
• Chewed wrapped in betel leaves or with tobacco
• Available as commercial preparations in some countries
• One of the most widely consumed addictive substances: estimated 10% of world population
• Consumption often starts at a young age
• Contains four main alkaloids
• Arecoline
• Arecaidine
• Guvacoline
• Guvacine

Mechanism

• Parasympahetic nervous system stimulant via muscurininc receptors
• Potentiates GABA
• Catecholamine release

Indications

• Drug of abuse
• Claimed to calm the digestive system

Side Effects/Precuations/Contraindications

• Side Effects
• Euphoria
• Relaxation
• Facial flushing, sweating
• Salivation
• Gingival discoloration (red/orange)
• Palpitations, tachycardia
• Hypertension
• Elevated body temperature
• Prostate hyperplasia
• Increased T3, T4
• Hepatotoxic
• Immunosupression: T cell supression
• Oral cancer: mouth and oesophagus
• Withdrawal Syndrome
• Insomnia
• Mood swings
• Irritability
• Anxiety
• Precautions
• May develop tolerance/resistance to Benzodiazapines (BZDs)
• Schizophrenia: worsens positive and negative symptoms
• Ischaemic Heart Disease (IHD): increased risk
• Hyperthyroidism: increased T3 and T4 release
• Contraindications
• Pregnancy: increased incidence of low birth weight babies and preterm labour
• Chronic Liver Disease: hepatotoxic





Gingival discoloration from chronic Betel Nut use

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References

Garg A, Chaturvedi P, Gupta P. A review of the systemic adverse effects of areca nut or betel nut. Indian Journal of Medical Paediatric Oncology. 2014;35(1):3-9.