Nymphaea caerulea, also known as blue lotus flower, is a water lily that was grown by the ancient Egyptians. They used to infuse the flowers in wine and to share the beverage during rituals, ceremonies and spiritual celebration. In fact, the extracts of the flower are capable of inducing altered states of consciousness thus it was used as a connection with the divine. The blue lotus was a central symbol for them and it was believed to represent the creation, death, the sun and the goddess of love. Blue lotus is mentioned in “the Egyptian book of the dead” as a vehicle to ascension and rebirth and it is called “the lily that shines in the earth”. 
In addition to Egyptian civilization, this plant has been revered by many other ancient cultures including Tibetans and Greeks among others.
Talking about Greek mythology, in Homer’s epic poem the Odyssey, Odysseus and his fellows, after days of navigation in the storm, landed on the island inhabited by the lotus-eaters. This race of people welcomed well Odysseus and his friends, offering them the sweet sprout of lotus. The characteristic of this primary food of the island was to have narcotic effects: all the lotus-eaters were in a kind of perpetual apathy and the friends of Odysseus who ate the lotus felt in the same mental state. The crew of Odysseus’ ship was forced to go on board by their captain Odysseus, otherwise they would have completely forgotten the longed-for homeland. 
Even if there is some ambiguity in the botanical classification of the plant mentioned in the Odyssey, based on Herodotus assertions it is possible to identify various species of water lily, including the Nymphaea caerulea. In fact this plant was already known by the Greeks under the name of blue lotus and it was known to be soporific and in some formulations also psychotropic.
The reason why this plant is so important and famous resides in its chemical composition. In fact the two alkaloids contained in the blue lotus flower, apomorphine and nuciferine, are responsible for the psychoactive effects that the plant can induce. 
Chemical composition of Nymphaea caerulea
This plant is known for its multifaceted therapeutic action and it is also used in Ayurvedic medicine as treatment for liver disorders. The extraction of the full phytochemical composition of the blue lotus can be performed using solvents with different polarities including water, methanol, ethanol and chloroform. 
The phytochemical screening of various parts of the blue lotus plant including roots, rhizomes, leaves and flowers shows a variegate composition including:
It should be noticed that leaves and flowers of blue lotus have a higher variety and concentration of secondary metabolites compared to rhizomes and roots. In fact flowers and leaves contains also:
The anti- inflammatory, antispasmodic, anti-cancer, anti-microbial, analgesic, anti-oxidants and diuretic activities can be attributed due to the presence of higher levels of steroids, tannins, terpenoids, flavonoids, phenols, emodins and saponins. 
Regarding the psychotropic activity of the blue lotus extract and the potential intoxicating effects at high doses we will describe the two alkaloids contained in high concentration mainly in blue lotus flowers and leaves: apomorphine and nuciferine.
This non selective dopamine receptor agonist is capable of activating serotonin and adrenergic receptors. This compound, contrary to its name, doesn’t bind to opioid receptors and is not structurally related to morphine.  It was used since ancient times as a sedative-hypnotic agent and more recently to relieve the anxiety of alcoholics or heroin addicts. Moreover apomorphine can exert emetic action and it can treat erectile dysfunction. Nowadays it is used in the treatment of Parkinson’s disease and Alzheimer’s disease.
The main contraindications of apomorphine are:
- fluid accumulation in the limbs
- persistent erections
This alkaloid is an antagonist at 5-HT2A, 5-HT2C, and 5-HT2B, an inverse agonist at 5-HT7, a partial agonist at D2, D5 and 5-HT6, an agonist at 5-HT1A and D4 receptors, and inhibits the dopamine transporter.  This compound was investigated for its potential health benefits as antipsychotic medication and as treatment for vascular diseases.  Nuciferine has enhanced permeability in the blood brain barrier and an interesting poly-pharmacological profile.  Moreover it is capable of counteracting the morphine induced analgesia due to enhancing effects of pain perception. Nevertheless depending on the dosages it could also potentiate the effects of morphine analgesia.
Nuciferine can elicit a variety of therapeutic effects including: 
- anti-tumor effects
- affinity to neural receptors
Toxicity of Nymphaea caerulea
Blue lotus is sold in various forms including dried flowers, dried plant materials, extracts, incense, teas, oils and powders. A growing number of intoxication cases have been reported about this plant derived extract consumed in electronic cigarettes or infused in beverages. The improved modifiability of modern vaping devices by the end user has allowed experimentation with non-traditional products, for which there is limited literature to provide guidance to healthcare providers. The intoxication cases treated in the first aid centers presented signs of altered mental status, hallucinations, drowsiness, tachycardia, anxiety, chest pain among other intoxication symptoms. 
Moreover electronic cigarettes successfully improve the bioavailability of the main alkaloids found in blue lotus extracts such as apomorphine and nuciferine, permitting a good absorption through inhalation. Insights about the right dosages to experience the benefits instead of the hallucinating effects are still anecdotal and more studies should be done in order to reveal the potential long term adverse effects of blue lotus extracts.
Wrap-up on Blue lotus extracts and legal considerations
As mentioned before, blue lotus is capable of inducing hallucinations and euphoria at high dosages. The recreational use of blue lotus extracts is increasing and for this reason some countries are starting to include the plant among the illicit substances class I.
The states that for now consider illegal the possession and distribution of blue lotus material are Latvia, Poland and Russia. In the USA blue lotus is not currently included in the controlled substances, so it can be legally sold in most states. Nevertheless it is not meant for human consumption and it is not approved and regulated by the Food and Drug Administration (FDA).
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 Mackenzie Schimpf, Thomas Ulmer, Hugh Hiller, Alexander F Barbuto, Toxicity From Blue Lotus (Nymphaea caerulea) After Ingestion or Inhalation: A Case Series, Military Medicine, Volume 188, Issue 7-8, July/August 2023, Pages e2689–e2692, https://doi.org/10.1093/milmed/usab328