
A recent link on Digg led me to a (UK) Telegraph article about a fish called sarpa salpa, normally found in the Mediterranean, that was recently caught off the coast of England. The article explains:
Sarpa salpa are a popular dish in many Mediterranean restaurants.
But according to marine experts, certain species of plankton-eating fish, like the sarpa salpa, can give off hallucinogenic fish poisoning if the heads or other body parts are consumed.
The effects include vivid hallucinations within minutes of eating it which can last for days.
In 2006 two men, one aged 90, were hospitalised in the south of France after eating sarpa salpa.
The elderly man suffered from auditory hallucinations a couple of hours after eating the fish followed by a series of nightmares over the next two nights.
The younger man, aged 40, endured similar effects which took 36 hours to disappear.
I’ve had an interest in hallucinogens for a long time. I thought I knew them all. Tryptamines, phenethylamines, the Colorado River Toad, from which the urban legend about “toad licking” probably originated. Unfortunately, the Colorado River Toad contains 5-MeO-DMT and 5-HO-DMT, both of which are metabolized by monoamine oxidase in the GI tract, so they are not orally active. You can’t get high by licking the toad. However, the milky secretion that contains these drugs can be squeezed out of two glands at the corners of the toad’s mouth (those glands are the evolutionary ortholog to our parotid gland). The secretions can then be dried and smoked.

But I’ve never heard of this fish, so I investigated further. First, I’m surprised how little information exists about sarpa salpa. Maybe I shouldn’t be. Maybe that’s why I’ve never heard of it. PubMed brings back only seven results from scientific journals, and only three of them appear to be about the fish. Two are case reports of poisoning. There is no Wikipedia article, although Sarpa salpa is mentioned in one article with a long taxonomic list of species.
A Google search brings back a page on the Practical Fishkeeping web site which describes sarpa salpa like this:
Two men have suffered terrifying visual and auditory hallucinations after eating a popular local seafish in Mediterranean restaurants.
According to a clinical study on the patients, which is due to be published in the journal Clinical Toxicology [more on this later], the men started seeing and hearing things after contracting a rare form of hallucinogenic poisoning from the Salema fish they were dining on…
The effects of eating ichthyoallyeinotoxic fishes, such as certain mullet, goatfish, tangs, damsels and rabbitfish, are believed to be similar to LSD, and may include vivid and terrifying auditory and visual hallucinations. This has given rise to the collective common name for ichthyoallyeinotoxic fishes of “dream fish”….
[T]he men had both eaten a fish called Sarpa salpa, and subsequently suffered from CNS disturbances including terrifying hallucinations and nightmares.
One of the men, a 40-year old, was admitted to hospital suffering from a digestive problem and frightening visual and auditory hallucinations, which took 36 hours to disappear. The second man, a 90-year old, suffered from auditory hallucinations a couple of hours after eating the same species of fish, followed by a series of nightmares over the next two nights.
The poisoning can start to cause vivid hallucinations within minutes of eating a poisonous fish and may last for days, often with no other effects. There is no antidote.
Indoles [from which tryptamines are derived], with similar chemical effects to LSD (lysergic acid diethylamide) are believed to be responsible and may be consumed when the fish eat algae or phytoplankton containing the chemicals.
Others have claimed that different species of ichthyoallyeinotoxic fishes, such as Kyphosus fuseus, contain much more potent hallucinogens, such as dimethyltryptamine or DMT, which is considered to be one of the world’s most mind-bending hallucinogenic chemicals.
(Emphasis mine.)
It’s a fascinating report, but I have some problems with it. First, remember when I said 5-MeO-DMT and 5-HO-DMT can’t be consumed orally? The same holds true for DMT. Recreational drug users smoke it, although all these drugs can be taken orally with an MAO inhibitor. Assuming there’s no natural MAO inhibitor present in the fish, and assuming these men didn’t happen to be taking MAO inhibitors for medical reasons (they were replaced by better antidepressants long ago), it is unlikely that the active hallucinogen is DMT. The only potent tryptamines that can be consumed orally are 4-substituted tryptamines, like 4-HO-DMT (psilocin) and its phosphate ester (psilocybin), the active hallucinogens in magic mushrooms. Does this fish contain psilocin?
Well, there’s another problem. The profile of the “poisoning” doesn’t sound anything like “trip reports” of psychedelic tryptamines. Onset within minutes, can last for days, apparently people can sleep in that state, but they experience vivid nightmares. That just doesn’t sound like the popular tryptamines.
While reading that article, I got the distinct impression that the drug must be something else. But what is it?
I mentioned earlier that two of the seven articles listed on PubMed were case reports of poisoning. The Practical Fishkeeping article mentions a report due to be published in Clinical Toxicology. That’s one of the articles listed on PubMed, from 2006. The other is from 1988 and doesn’t exist online, but the 2006 article does. So I retrieved it.
First, the paper, published in a peer-reviewed scientific journal, avoids hearsay and admits that the cause is unknown. Then it describes the two cases:
CASE 1
April 1994
A previously healthy 40-year-old executive began feeling weak and tired within 2 h after eating freshly caught baked sea bream (Sarpa salpa) for dinner while on vacation in Cannes on the French Riviera. Nausea and vomiting developed quickly during the night. The next day symptoms persisted and were accompanied by marked muscle weakness. He decided to shorten his vacation and drive home. At that point, he began toexperience blurring of vision and hallucinations involving aggressive and screaming animals. Agitation and disorientation led him to seek medical assistance (he was not able to drive anymore as he was seeing giant arthropods around his car). Physical examination upon arrival at the hospital emergency room demonstrated no notable abnormalities: no fever, no sign of focalization or sensory-motor deficit, and normal hemodynamic status except for sinusal tachycardia linked directly to the mental disturbances. During hospitalization, the patient recovered rapidly with complete resolution of symptoms within 36 h post ingestion. He was unable to recall the hallucinatory period.
CASE 2
March 2002
A previously healthy 90-year-old retiree began experiencing auditory hallucinations 2 h after ingesting a sea bream (Sarpa salpa) that he had purchased from a professional fisherman in Saint Tropez on the French Riviera. He was used to eating this kind of fish, and had cleaned the fish after he had purchased it. Hallucinations were of a particularly terrifying nature (human screams and bird squealing), and he had numerous nightmares for the next two nights. Fearing that these symptoms might signal the beginning of a major mental illness, he did not tell his friends or attending physician. The manifestations abated three days after he had eaten the fish. Later, he recalled a warning that he had heard at the fish market concerning the hallucinogenic potential of sea bream and decided to contact the Poison Control Center in Marseille.
Crazy shit. One thing you’ll notice is that the Telegraph article got it wrong. The case reports were published in 2006, but neither man was poisoned that year (these are definitely the same men mentioned in the Telegraph article. What are the odds that two other men, one aged 40 and the other 90, were poisoned?) The paper continues:
DISCUSSION
Clinical symptoms of ichthyoallyeinotoxism occur within a few minutes to 2 h after ingestion of toxic fish. The first symptoms resemble inebriety with loss of balance and coordination and generalized malaise (1–3). Sore throat and heartburn have also been reported in the initial phase. Within a few hours, specific signs of poisoning occur including delirium, visual and/or auditory hallucinations (often involving animals), depression, feelings of impending death with reactive tachycardia and hyperventilation, and disturbed behavior. If they are able to sleep, patients classically report terrifying nightmares (3). Gastrointestinal symptoms including nausea, abdominal pain, and diarrhea have been described in a few cases, but are usually low-grade (3). No specific treatment or antidote treatment is available. Appropriate management of transient behavioral disturbances (e.g., using benzodiazepine or neuroleptics), is important to prevent self-inflicted or other injury. Symptomatictreatment for gastrointestinal manifestation can enhance patient comfort. Symptoms generally abate within 24 to 36 h, but weakness may persist for several days (1–3).
Ichthyoallyeinotoxism is widespread in tropical and temperate areas of the Indian and Pacific Oceans as well as in the Mediterranean Sea. Toxic fish species belong to the 8 families detailed in Table 1. Most are herbivores or scavengers living in coastal areas. It should be noted that toxicity in all species varies according to fishing location, season, and way of preparing the fish (3). In the Mediterranean, most poisonings involving Sarpa salpa (eaten in Tunisia, France and Israel but considered as inedible in Italy and Spain), have been reported in spring and summer (4–7). A classically reported exacerbating factor is consumption of fish cooked without removing the head, and/or not immediately gutted after being caught (8). Although the toxic agents are still unknown, some authors have implicated toxic macroalgaes (caulerpaceae family) that are ingested and contaminate the flesh of fish (3,4). These toxins are probably heat stable since case reports have been described after ingestion of fried, boiled, steamed or raw fish (3,7)
Now we have a lead. Caulerpaceae microalgae. Perhaps it’s not the fish that produces the toxin after all. That might explain why cases of poisoning are rare despite sarpa salpa being a common menu item around the Mediterranian Sea and Indian Ocean. Only fish infected by caulerpaceae algae cause hallucinations.

What do we know about the toxins in these organisms? A search for “caulerpaceae hallucinogen” brings back nothing. However, “caulerpaceae toxin” reveals a class of toxins that include caulerpenyne, caulerpenin, caulerpicin, and caulerpin, which appear to be neurotoxins that act on ion channels and have some effects “similar to serotonin”. The last point is interesting, because classical psychedelics, the phenethylamines and tryptamines, are known to act via the 5-HT2A receptor (serotonin receptor subtype 2A).
So what are the known effects of caulerpaceae toxins in humans? I couldn’t find anything. I searched for hours. I thought the trail had gone cold. But then I found this:

The molecular structure of caulerpin. My jaw almost dropped when I saw it. What’s so special about it?
It has two indoles:

Not only that, but caulerpin’s multi-ring structure lends itself to a rigid planar stereochemistry, much like LSD (which some have argued potentiates LSD’s effects). It also lacks the amine of classical tryptamines, which is one place that monoamine oxidases attack to metabolize tryptamines via the oral route (the nitrogen would be at the position where the methyl esters bond to the central ring). In fact, other than the conspicuous lack of that nitrogen, caulerpin looks like two tryptamines fused together. This may very well be the culprit.
However, many questions remain. What is the action of caulerpin in the human CNS? How does it avoid metabolism in the GI tract without the 4-substitution on its indoles? If this is the hallucinogen, why do its effects last so much longer than other tryptamines? This is not the end of my investigation, but the beginning.