Harmless brew of fact and fiction
“Ugly Betty,” Episode: Odor in the Court, ABC, Jan. 17.
The Premise: Betty Suarez (America Ferrera) is unwittingly using a poisoned perfume that may have driven Claire Meade (Judith Light) crazy over six months and caused her to commit murder. The perfume makes Betty feel powerful and passionate, and she begins to crave it -- spraying it on her skin and frequently inhaling it.
But she also sweats profusely and begins to complain of headaches and dry mouth as well as feeling hot, itchy, irritable and overly emotional.
Finally, she becomes so paranoid, hyperactive and aggressive that she smashes the window of a deli and is taken to the hospital. There, her family doctor examines her and finds the pupils of her eyes dilated, her heart rate elevated and her lymph nodes swollen. He tells her that she must have high levels of a toxic chemical in her body.
Her blood is tested, and the results show “methyldexedrine, limben and fitzident,” with traces of toad venom, which the doctor identifies as Bufo alvarius.
He says that this toxic potion explains Betty’s symptoms and could lead to excess paranoia and hallucinations and even be fatal but that in Betty’s case it has worn off until “the levels are almost normal.” She is released from the ER and improves without treatment.
The medical questions: Are the chemicals described in the perfume real and do they have these particular effects on behavior and physiology? Would the chemicals work through skin absorption or inhalation? Would treatment be necessary, or just observation? Could the concoction be fatal?
The reality: Fitzident and limben are fictitious chemicals, but dexedrine is a commonly used amphetamine that can cause rapid heart rate, sweating, dilated pupils, dry mouth and feelings of power and aggression similar to what Betty experiences. Toad venom from the Bufo genus, or bufotoxin, is predominantly a cardiac glycoside, like digoxin. This type of chemical would not cause Betty’s symptoms but would cause the heart to contract harder, slow the heart rate and could cause seizures, says Jim Adams, associate professor of pharmacology at USC.
However, toad venom also contains stimulants, including adrenaline and noradrenaline, as well as tryptamines, which in the Sonoran desert toad, or Bufo alvarius, can cause psychedelic and psychoactive effects such as Betty experiences, especially when inhaled.
“In reality, very little of these chemicals would be absorbed through the skin,” Adams says. “But the perfume could be inhaled.” Betty’s swollen lymph nodes are not characteristic of any of these chemicals and are clearly invented by the show for dramatic effect.
Finally, such a perfume could be fatal because of its combined and dissimilar effects on the heart. Dialysis could be used to rapidly remove the amphetamine, with digoxin-specific antibody fragments given to bind and remove the cardiac glycoside of the toad venom.
In Betty’s case, with only trace amounts of the chemicals found in her blood, it is realistic that no treatment is offered. But given how sick she has been, in the real world she would at least be observed overnight in the hospital.
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Dr. Marc Siegel is an internist and an associate professor of medicine at New York University’s School of Medicine. He is also the author of “False Alarm: The Truth About the Epidemic of Fear.” In the Unreal World, he explains the medical facts behind the media fiction. He can be reached at marc@doctorsiegel.com.