Hostname: page-component-7c8c6479df-r7xzm Total loading time: 0 Render date: 2024-03-27T17:25:20.681Z Has data issue: false hasContentIssue false

Herbal mania: a diagnostic dilemma?

Published online by Cambridge University Press:  13 June 2014

Brendan D Kelly
Affiliation:
Stanley Research Centre, St John of Gods Hospital, Stillorgan, Dublin, Ireland
Ben Ogburn
Affiliation:
Hawke's Bay Memorial Hospital, Omahu, Road, Hastings, New Zealand

Abstract

A case of affective psychosis and cognitive impairment is described. The patient had a history of cerebrovascular disease and had been ingesting large quantities of a complex herbal tonic prior to presentation. Diagnostic issues are discussed. Relevant literature on cerebrovascular disease and herbal remedies is reviewed. We propose a stress-diathesis model to account for this patient's illness and we advise caution in the use of complementary therapies in patients with compromised cerebrovascular status. Appropriate practice guidelines are outlined.

Type
Case Reports
Copyright
Copyright © Cambridge University Press 2001

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.MacLennan, AH, Wilson, DH, Taylor, AW. Prevalence and cost of alternative medicine in Australia. Lancet 1996; 347: 569–73.CrossRefGoogle ScholarPubMed
2.Ernst, E. Second thoughts about safety of St John's wort. Lancet 1999; 3.54: 2014–16.CrossRefGoogle Scholar
3.Lishman, WA. Organic Psychiatry: The Psychological Consequences of Cerebral Disorder (3rd ed.). Oxford: Blackwell Science, 1998.Google Scholar
4.Levine, DN, Finklestein, S. Delayed psychosis after right temporoparietal stroke or trauma: relation to epilepsy. Neurology 1982; 32: 267–73.CrossRefGoogle ScholarPubMed
5.Van der Lugt, PJM, De Visser, AP. Two patients with a vital expansive syndrome following a cerebrovascular accident. Psychiatria, Neurologia, Neurochirurgia 1967; 70: 349–59.Google ScholarPubMed
6.Starkstein, SE, Boston, JD, Robinson, RG. Mechanisms of mania after brain injury. 12 case reports and review of the literature. J Nerv Mental Dis 1988; 176: 87100.CrossRefGoogle ScholarPubMed
7.Walter, G, Rey, JM. The relevance of herbal treatments for psychiatric practice. Australian and New Zealand Journal of Psychiatry 1999; 33: 482–89CrossRefGoogle ScholarPubMed
8.Josefson, D. Herbal stimulant causes US deaths. BMJ 1996; 312: 1441.CrossRefGoogle ScholarPubMed
9.Doyle, H, Kargin, M. Herbal stimulant containing ephedrine has also caused psychosis. BMJ 1996; 313: 756.CrossRefGoogle ScholarPubMed
10.Ruschitzka, F, Meier, PJ, Turina, M, Luscher, TF, Noll, G. Acute heart transplant rejection due to St John's wort. Lancet 2000; 355: 548–9.CrossRefGoogle Scholar
11.Linde, K, Mulrow, CD. St John's wort for depression (Cochrane Review): In: The Cochrane Library, Issue 3, 2000. Oxford: Update Software.Google Scholar
12.Gaster, B, Holroyd, J. St John's Wort for Depression: A Systematic Review. Arch Int Med 2000; 160: 152–6.CrossRefGoogle ScholarPubMed
13.Woelk, H. Comparison of St John's wort and imipramine for treating depression: randomised controlled trial. BMJ 2000; 321: 536–9.CrossRefGoogle ScholarPubMed
14.Yager, J, Siegfreid, SL, DiMatteo, TL. Use of Alternative Remedies by Psychiatric Patients: Illustrative Vignettes and a Discussion of the Issues. Am J Psychiatry 1999; 156: 1432–8.CrossRefGoogle Scholar