Sarı kantaronun (Hypericum perforatum) neden olduğu psikotik atak: Olgu sunumu

Öz

Son yıllarda doğal ürünlere ilginin giderek artması ile bitkisel tedavilerin kullanımı tüm dünyada giderek yaygınlaşmaktadır. Bitkisel tedaviler içerisinde psikiyatrik bozuklukların tedavisi amacıyla sıklıkla kullanılanlar arasında, sarı kantaron olarak da bilinen Hypericum perforatum da yer almaktadır. Sarı kantaron, başta hafif ve orta şiddetteki depresyon olmak üzere, uykusuzluk ve kaygı gibi belirtilerin tedavisinde kullanılmaktadır. Etki mekanizması tam olarak aydınlatılmamış olmasına rağmen aktif bileşenlerinin antidepresan etkiye sahip olduğu düşünülmektedir. Yazımızda, 47 yaşında, daha önce psikoz öyküsü olmayan ve sarı kantaron kullanımı sonrası psikotik hecme geçirdikten sonra antipsikotikle başarılı şeklide tedavi edilen bir kadın hasta sunulmuştur.

Anahtar Kelimeler

• sarı kantaron, psikotik atak, bitkisel tedavi

Psychotic episode induced by St. John’s wort (Hypericum perforatum): a case report

Öz

There is an increase in the use of herbal therapies in recent years. St. John’s Wort (SJW), which is also named as Hypericum perforatum, is one of the most frequently used herbal agents in the treatment of psychiatric disorders. SJW has been shown to be efficacious in treating mild to moderate depression, insomnia, and anxiety disorders. Although exact mechanism of action is not completely understood, its active components are suggested to have antidepressant properties. Despite its beneficial therapeutic effects, SJW can also cause unexpected adverse effects. Herein, we present the case of a 47-year-old, previously healthy female who developed psychosis after taking SJW extract and successfully treated with antipsychotic therapy.

Anahtar Kelimeler

• herbal therapy, psychosis, St. John’s wort

Kaynakça

1. Bruhn JG. The use of natural products in modern medicine [phytotherapy]. Acta Pharmaceutica Nordica. 1989;1:117-30.
2. Unutzer J, Klap R, Sturm R, Young AS, Marmon T, Shatkin J, Wells KB. Mental disorders and the use of alternative medicine results from national survey. Am J Psychiatry. 2000;157:1851-7.
3. World Health Organization (WHO). National policy on traditional medicine and regulation of herbal medicines Report of a WHO global survey; 2005.
4. Dhingra S, Parle M. Herbal remedies and nutritional supplements in the treatment of depression: a review. BCP. 2012;22:286-92.
5. Hammerness P, Basch E, Ulbricht C, Barrette EP, Foppa I, Basch S, Bent S, Boon H, Ernst E; Natural Standard Research Collaboration. St John’s wort: a systematic review of adverse effects and drug interactionsfor the consultation psychiatrist. Psychosomatics. 2003;44:271-82.
6. Clement K, Covertson CR, Johnson MJ, Dearing K. St. John’s wort and the treatment of mild to moderate depression: a systematic review. Holist Nurs Pract. 2006;20:197-203.
7. Stevinson C, Ernst E. A pilot study of Hypericum perforatum for the treatment of premenstrual syndrome. BJOG. 2000;107:870-6.
8. Schulz V. Safety of St. John’s wort extract compared to synthetic antidepressants. Phytomedicine. 2006;13:199-204.

9. Zhou S, Chan E, Pan SQ, Huang M, Lee EJ. Pharmacokinetic interactions of drugs with St John’s wort. J Psychopharmacol. 2004;18:262-76.
10. Güzelcan Y, Scholte WF, Assies J, Becker HE. Mania during the use of a combination preparation with St. John’s wort (Hypericum perforatum).Ned Tijdschr Geneeskd. 2001;145:1943-15.
11. Lal S, Iskandar H. St. John’s wort and schizophrenia. CMAJ. 2000;163:262-3.
12. Shimizu K, Nakamura M, Isse K, Nathan PJ. First episode psychosis after taking an extract of Hypericum perforatum (St. John’s wort). Hum Psychopharmacol. 2004;19:275-76.
13. Butterweck V. Mechanism of action of St John’s wort in depression: what is known? CNS Drugs. 2003;17:539-62.
14. Yoshitake T, Iizuka R, Yoshitake S, Weikop P, Müller WE, Ogren SO, Kehr J. Hypericum perforatum L (St John’s wort) preferentially increases extracellular dopamine levels in the rat prefrontal cortex. Br J Pharmacol. 2004;142:414-8.