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Although bittersweet nightshade is not the same plant as deadly nightshade or belladonna (an uncommon and extremely poisonous plant), it is poisonous and has caused loss of livestock and pet poisoning and has caused death in children who accidentally picked the berries, probably because it was growing with blackberries. Bittersweet nightshade also has a strong, unpleasant odor so most animals will avoid it and poisonings from this plant are not very frequent.

The entire plant contains solanine, the same toxin found in green potatoes and other members of the nightshade family, and it also contains a glycoside called dulcamarine, similar in structure and effects to atropine, one of the toxins found in deadly nightshade. The toxin amount varies with soil, light, climate and growth stage. Ripe fruits are less toxic than the leaves and unripe berries but even ripe berries can be poisonous.

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