Transdermal Ginseng Patches as a Rare Trigger of Psychosis: Implications for Herbal Product Safety

Öz

This case report describes a 49-year-old woman who developed ginseng-induced psychosis after using transdermal ginseng patches. Presenting with visual hallucinations, disorganized thoughts, and anxious behavior, she had no prior psychiatric history. Diagnostic tests, including brain imaging and EEG, were normal. The patient’s symptoms resolved after discontinuing the patches and receiving risperidone. Ginseng, commonly used for physical and mental fatigue, rarely causes psychosis. This case highlights the potential psychiatric side effects of herbal products, particularly transdermal forms, which lack regulatory oversight. Emergency physicians should consider herbal use in patients with psychotic symptoms, emphasizing the need for caution and regulation of such products.

Anahtar Kelimeler

• Ginseng
• Herbal medicine
• Psychotic disorders
• Transdermal patch
• Adverse drug reaction

Transdermal Ginseng Yamaları ve Psikoz İlişkisi: Bitkisel Ürün Güvenliğinin Önemi

Öz

Bu vaka raporu, transdermal ginseng bantları kullandıktan sonra ginseng kaynaklı psikoz geliştiren 49 yaşında bir kadını anlatmaktadır. Görsel halüsinasyonlar, dağınık düşünceler ve kaygılı davranışlar sergileyen hastanın öncesinde psikiyatrik öyküsü yoktu. Beyin görüntüleme ve EEG dahil tanısal testler normaldi. Hastanın semptomları, bantların kesilmesi ve risperidon tedavisi sonrasında tamamen düzeldi. Fiziksel ve zihinsel yorgunluk için yaygın olarak kullanılan ginseng, nadiren psikoza neden olur. Bu vaka, özellikle düzenleyici denetimden yoksun transdermal formlar da dahil olmak üzere bitkisel ürünlerin potansiyel psikiyatrik yan etkilerini vurgulamaktadır. Acil hekimleri, psikotik semptomları olan hastalarda bitkisel ürün kullanımını göz önünde bulundurmalı ve bu tür ürünlerin dikkatli kullanımı ve düzenlenmesi gerekliliğini vurgulamalıdır.

Anahtar Kelimeler

• Ginseng
• Bitkisel ilaç
• Psikotik bozukluklar
• Transdermal yama
• İstenmeyen ilaç reaksiyonu

Kaynakça

1. 1. Kim JH, Yi YS, Kim MY, et al. Role of ginsenosides, the main active components of Panax ginseng, in inflammatory responses and diseases. J Ginseng Res. 2017;41(4):435–443.
2. 2. Lee NH, Yoo SR, Kim HG, et al. Safety and tolerability of Panax ginseng root extract: a long-term follow-up study. J Ginseng Res. 2012;36(4):331–335.
3. 3. Lee S, Rhee DK. Effects of ginseng on stress-related depression, anxiety, and the hypothalamic-pituitary-adrenal axis. J Ginseng Res. 2017;41(4):589–594.
4. 4. Tsuang MT, Faraone SV. The genetics of mood disorders. Baltimore, MD: Johns Hopkins University Press; 1990.
5. 5. Izzo AA, Ernst E. Interactions between herbal medicines and prescribed drugs: a systematic review. Drugs. 2009;69(13):1777–1798.
6. 6. Henderson GL, Harkey MR, Gershwin ME. Effects of ginseng components on cDNA-expressed cytochrome P450 enzyme catalytic activity. Life Sci. 1999;65(15):PL209–PL214.
7. 7. Prausnitz MR, Langer R. Transdermal drug delivery. Nat Biotechnol. 2008;26(11):1261–1268.
8. 8. Boullata JI, Nace AM. Safety issues with herbal medicine. Pharmacotherapy. 2000;20(3):257–269.

9. 9. Barnes J, Mills SY, Abbot NC, et al. Different standards for reporting ADRs to herbal remedies and conventional OTC medicines: face-to-face interviews with 515 users of herbal remedies. Br J Clin Pharmacol. 1998;45(5):496–500.
10. 10. Qi LW, Wang CZ, Yuan CS. Ginsenosides from American ginseng: chemical and pharmacological diversity. Phytochemistry. 2011;72(8):689–699.
11. 11. Joshi KG, Faubion MD. Mania and Psychosis Associated with St. John’s Wort and Ginseng. Psychiatry. 2005;2(9):56–61.