Abstract
Celery root belongs to a group of plants classified as the umbelliferous family, which contains phytoestrogens. Phytoestrogens are structurally similar to estrogen as they share a pair of hydroxyl groups and phenolic ring, which enables them to bind to estrogen receptors directly, making them a herbal remedy for low estrogen states such as menopause. We present a case of a female patient with depression who was stabilized on venlafaxine and St John's Wort, and who developed a manic episode due to elevated serum venlafaxine levels after she started taking celery extracts for menopausal related issues. We proffer a hypothesis for this unusual occurrence.
Keywords:
Celery root; St John’s worth; bipolar disorder; mania; venlafaxine.
MeSH terms
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Antidepressive Agents, Second-Generation / administration & dosage
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Apium / adverse effects*
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Bipolar Disorder* / chemically induced
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Bipolar Disorder* / diagnosis
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Bipolar Disorder* / therapy
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Depressive Disorder, Major / diagnosis
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Depressive Disorder, Major / drug therapy*
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Female
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Herb-Drug Interactions
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Humans
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Hypericum*
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Menopause / drug effects
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Middle Aged
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Phytotherapy* / adverse effects
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Phytotherapy* / methods
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Plant Preparations / administration & dosage
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Plant Preparations / adverse effects
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Plant Roots / adverse effects
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Psychiatric Status Rating Scales
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Treatment Outcome
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Venlafaxine Hydrochloride / administration & dosage*
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Withholding Treatment
Substances
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Antidepressive Agents, Second-Generation
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Plant Preparations
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Venlafaxine Hydrochloride