Harmal
Do not self-treat with Harmal
If this is an emergency
Some reactions to Harmal need urgent care. Call your local emergency number or go to an emergency department straight away — do not wait to see whether it passes.
Who should avoid Harmal?
- Do not use if you are pregnant, might be pregnant, or are trying to conceive — harmal makes the womb contract and can cause miscarriage. There is no exception to this.
- Do not use if you are breastfeeding, as the alkaloids can pass into your milk.
- Do not use if you are giving it to a child, at any dose or in any form.
- Do not use if you take an antidepressant of any kind, including SSRIs, SNRIs, MAOIs or St John's wort — the mix can cause serotonin syndrome (a dangerous build-up of a brain messenger), which can kill.
- Do not use if you take tramadol, a triptan for migraine, dextromethorphan cough medicine, or the antibiotic linezolid.
- Do not use if you take medicine for Parkinson's disease, such as levodopa, selegiline or rasagiline.
- Do not use if you take stimulants, including amphetamines, cocaine or pseudoephedrine decongestants.
- Do not use if you plan to mix it into an ayahuasca-type brew: this combination has killed people.
- Do not use if you have liver disease or hepatitis (swelling of the liver), because harmal can injure the liver further.
- Do not use if you have kidney disease.
- Do not use if you have a heart rhythm problem, a slow heartbeat or low blood pressure.
- Do not use if you have epilepsy or any history of fits (seizures).
- Do not use if you have a mental health condition such as schizophrenia or bipolar disorder, as harmal can trigger hallucinations (seeing or hearing things that are not there).
- Do not use if you are about to drive, use machinery or have surgery in the next two weeks.
When should you see a doctor?
Call emergency services straight away if someone who has taken harmal has a fit, cannot be woken, has a very slow or racing heartbeat, breathes with difficulty, or becomes hot, stiff and confused. Take the packet or seeds with you.
Go to an emergency department the same day for repeated vomiting, severe dizziness or fainting, blurred vision, strong shaking, or seeing things that are not there.
See your doctor within a day or two if you notice yellow skin or eyes, dark urine, pain under your right ribs, or you are passing much less urine than usual. These can be signs of liver or kidney injury.
Tell any doctor or pharmacist that you have taken harmal, even if you feel fine. It changes how many common medicines work.
- What it is: Harmal is the seed of Peganum harmala, a desert plant used in Persian and Unani medicine and burned as incense.
- Active ingredients: Harmine, Harmaline, Harmalol, Harmol, Vasicine, Vasicinone
- Side effects: Nausea and vomiting are common; fits, liver and kidney damage and death have been reported.
- Pregnancy & breastfeeding: Avoid in pregnancy and while breastfeeding.
Educational information, not medical advice — ask your doctor or midwife.
What is Harmal?
Harmal is the seed of a small desert plant, Peganum harmala. It is also called wild rue or Syrian rue. In Persian and Unani medicine, the seeds were burned as smoke or given in very small doses for pain, worms and low mood.
Today harmal is best known for its strong plant chemicals, called beta-carbolines (nerve-acting compounds). They change brain chemistry. They can also poison you, and people have died after taking too much.
There are no sound human trials showing that harmal treats any illness. Long use in tradition is not proof that a thing works. We list it here so you can read the real risks, not so you can take it.
How does Harmal work?
Harmal's effects come mainly from beta-carbolines, a group of strong plant chemicals. The best known are harmine and harmaline.
In lab tests, these block MAO-A, an enzyme (a body protein that speeds up a chemical change). That enzyme breaks down serotonin and other brain messengers. When it is blocked, those messengers build up.
That same action is why harmal reacts so badly with many drugs and some foods. It can push blood pressure up fast, or cause a dangerous build-up of serotonin.
All of this is lab work and case reports, not proof of benefit in people. The strongest thing we can say is that harmal is active and risky, not that it helps.
What forms does Harmal come in?
Whole and crushed seeds are the main form. Seed powder, decoctions (boiled water extracts) and tinctures (alcohol extracts) are also sold.
Dried seed pods are widely sold as incense to burn. Harmal is also sold online as 'Syrian rue' to mix with other plants into strong mind-altering brews. That use has caused severe poisoning and is not medical use.
A red dye from the seed is used for rugs and cloth. Dye use is not a sign that the seed is safe to swallow.
Where it comes from:
Harmal is old in the Persian world. The dried seed pods, called esfand, are burned as smoke at weddings and births to ward off the evil eye. That custom is still alive today.
Unani texts list harmal as a warming single drug. Healers gave it for joint pain, worms, late periods and low spirits.
Greek and Arabic writers described it too, and North African healers still use it. So its standing in tradition is broad and very old.
What does Harmal help with?
- Joint and muscle pain: Unani texts call harmal a warming drug for stiff, painful joints. Some lab and animal work shows it calms swelling. No good human trial backs this use, and safer options for joint pain exist.
- Intestinal worms: Old Persian and Unani use includes killing gut worms. Lab tests show the alkaloids can harm worms in a dish. There are no reliable human trials, and modern worm medicines are both safe and cheap.
- Low mood: Harmine blocks MAO-A, the same enzyme some older antidepressant drugs block. That has led to interest in harmal for low mood. We could not find a proper human trial, and mixing harmal with antidepressant drugs can be deadly.
- Late or missing periods: Tradition uses harmal to bring on a period. It does make the womb contract, which is why it can also cause miscarriage. We do not advise this use at all; if your periods stop, see a doctor to find out why.
- Skin parasites such as scabies: Seed oil or paste has been rubbed on the skin for itch, lice and scabies in North Africa and Iran. Evidence is limited to tradition and small lab studies. Harmal can be taken in through broken skin, so even this use carries risk.
- Trouble sleeping: Small doses were used as a calming drug in Unani practice. Harmal can indeed make you drowsy, but it can also cause a racing mind, seeing things that are not there, and shaking. It is not a sensible sleep aid.
What are the side effects of Harmal?
- Nausea and vomiting
- Stomach cramps
- Dizziness and unsteady walking
- Low blood pressure
- Slow heart rate and other heart rhythm changes
- Shaking and muscle twitching
- Blurred vision
- Seeing or hearing things that are not there
- Agitation and confusion
- Fits (seizures)
- Liver injury
- Kidney injury
- Red or orange colour in the urine
- Coma and death after large amounts
Good to know:
Stomach upset is common even at small amounts. Serious harm is not rare with this plant.
Hospital reports from Iran, Turkey and Morocco describe people who took harmal at home and needed intensive care. Fits, liver and kidney damage, and deaths are on record.
Because seed strength varies, a dose that was fine once can harm you the next time. Treat any amount as risky.
Options to discuss with a clinician
For every one of these problems there are routes with far better evidence behind them, and each is a conversation to have with a doctor, pharmacist or qualified herbalist rather than something to pick off a shelf.
- **Intestinal worms:** this is one of the few areas where standard treatment is cheap, single-dose and very reliable — a GP or pharmacist can confirm which worm is involved and treat the whole household. Clove Bud Extract is sometimes raised in herbal practice, but the evidence is thin, and it is worth asking a practitioner what it can and cannot do. - **Scabies and other skin parasites:** scabies needs a confirmed diagnosis, because several rashes look alike. Tea Tree Oil and Neem Oil both come up in discussions with herbalists, and Colloidal Oatmeal or Aloe Vera Topical are often mentioned for the itch that lingers after treatment. - **Joint and muscle pain:** ask a clinician to look for the cause — Quercetin is one option people raise, alongside physiotherapy and standard pain care. - **Low mood, trouble sleeping, and late or missing periods:** these three need assessment, not a herb. A missed period especially has causes — including pregnancy and thyroid problems — that change everything about what is safe.
Graded pages for the options named above:
- Aloe Vera Topical — evidence grade B, traditional tier T3
- Clove Bud Extract — evidence grade C, traditional tier T3
- Colloidal Oatmeal — evidence grade A, traditional tier T1
- Tea Tree Oil — evidence grade B, traditional tier T1
- Quercetin — evidence grade B, traditional tier T0
- Neem Oil — evidence grade C, traditional tier T3
Review status
This page has not been signed off by a pharmacist and is not published. It is shown here for a policy decision only.