People who take many herbal supplements need to be more aware of potential interactions among them in light of a recent case of a man who experienced hallucinations and visions of harming himself while taking 5 different supplements.
The 43-year-old man was checked into a psychiatric unit following a pattern of odd behaviors, including hallucinations, violent visions, a significant decline in sleep and appetite, and feelings of hopelessness.
The patient had no prior history of psychiatric issues, and was not using illegal drugs, prescription drugs, drinking alcohol in excess or smoking. A CT scan revealed no abnormalities in his brain.
However, lab tests revealed he was taking five dietary supplements designed to help lose weight and boost brain function, according to an article in The Primary Care Companion for CNS Disorders. The 5 supplements and their ingredients follow:
- Garcinia cambogia (chromium, Garcinia cambogia, green coffee bean extract, raspberry ketones)
- Brain Support (Asian ginseng powder, blueberry powder, ginger powder, ginko powder, grape powder, papaya powder)
- Brain Awake (Acetyl-l-carnitine, alphawave l-theanine, bacopa extract, bioperine black pepper, folate, ginger extract, Holy basil (Tulsi) extract [2% ursolic acid], InnovaTea natural tea extract, lemon balm extract, MCT [medium chain triglyceride] oil, rosemary extract [3% rosemarinic acid], Vitamin B6, Vitamin B12)
- Probiotic (Bifidobacterium bifidum, Bifidobacterium lactis, Lactobacillus acidophilus, Lactobacillus paracasei, Lactobacillus plantarum, Lactobacillus rhamnosus)
- Absorbmax (α-Galactosidase, β-Glucanase, amylase, aspergillopepsin, bromelain, cayenne pepper, cellulase, ginger rhizome, glucoamylase, hemicellulase, lactase, lipase, pectinase, peptidase, phytase, protease S, protease SP, Trace minerals, xylanase)
The man was given an antipsychotic and told to stop using the supplements. The psychotic episodes eventually ended and he was given a plan to ween off the antipsychotic and eventually discontinue taking it.
This case highlights some of the risks associated with taking supplements, since they are far less regulated by the FDA compared to prescription and over-the-counter drugs, and are not studied as much. Just because many of them derive from natural sources doesn’t mean they don’t have side effects.
Many times, doctors will not ask a patient what supplements they are taking. Since supplement-supplement interactions are a very real concern, be sure to tell your doctor about ones you are taking and immediately see your doctor if you experience side effects while taking them.
“When a patient presents with acute psychiatric symptoms, recent supplement use, and a seemingly negative history, physical examination, and test workup, identifying the effects of supplement usage may prove useful in directing clinical decision-making,” the authors conclude.