St John's wort (Hypericum perforatum)-induced psychosis: a case report

Area of Science:

• Psychiatry
• Pharmacology
• Herbal Medicine

Background:

• St. John's wort (Hypericum perforatum) is widely used for depression.
• Its over-the-counter availability raises concerns for unsupervised use in at-risk individuals.
• Limited evidence exists on Hypericum's effects in severe mental health conditions.

Observation:

• A 25-year-old male with a history of drug-induced psychosis and family history of psychotic depression self-administered St. John's wort.
• The patient presented with acute psychotic symptoms concurrently with Hypericum use.

Findings:

• This case highlights the potential for St. John's wort to precipitate psychotic features.
• The patient had a pre-existing vulnerability (psychotic diathesis).

Implications:

• Clinicians should be aware of Hypericum's potential to induce psychosis.
• Further research is needed on the risks of phytotherapeutics in vulnerable populations.
• Patients should be cautioned against haphazard use of herbal remedies like St. John's wort.