title: Celery root extract as an inducer of mania induction in a patient on venlafaxine and St John's Wort.
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.
authors.affiliation: a Department of Psychiatry , Central Michigan University College of Medicine , Saginaw , MI , USA.
authors.forename: Zaira
authors.initials: Z
authors.lastname: Khalid
authors.affiliation: a Department of Psychiatry , Central Michigan University College of Medicine , Saginaw , MI , USA.
authors.forename: Ferdnand C
authors.initials: FC
authors.lastname: Osuagwu
authors.affiliation: b Department of Family medicine , Central Michigan University College of Medicine , Saginaw , MI , USA.
authors.forename: Bilal
authors.initials: B
authors.lastname: Shah
authors.affiliation: a Department of Psychiatry , Central Michigan University College of Medicine , Saginaw , MI , USA.
authors.forename: Nikita
authors.initials: N
authors.lastname: Roy
authors.affiliation: a Department of Psychiatry , Central Michigan University College of Medicine , Saginaw , MI , USA.
authors.forename: James E
authors.initials: JE
authors.lastname: Dillon
authors.affiliation: a Department of Psychiatry , Central Michigan University College of Medicine , Saginaw , MI , USA.
authors.forename: Ronald
authors.initials: R
authors.lastname: Bradley
mesh_terms: D018687:Antidepressive Agents, Second-Generation / Q000008:administration & dosage; D000077102:Apium / Q000009:adverse effects*; D001714:Bipolar Disorder / Q000139:chemically induced / Q000175:diagnosis / Q000628:therapy; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D041743:Herb-Drug Interactions; D006801:Humans; D020902:Hypericum; D008593:Menopause / Q000187:drug effects; D008875:Middle Aged; D008517:Phytotherapy / Q000009:adverse effects / Q000379:methods; D028321:Plant Preparations / Q000008:administration & dosage / Q000009:adverse effects; D018517:Plant Roots / Q000009:adverse effects; D011569:Psychiatric Status Rating Scales; D016896:Treatment Outcome; D000069470:Venlafaxine Hydrochloride / Q000008:administration & dosage*; D028761:Withholding Treatment
chemical_list: D018687:Antidepressive Agents, Second-Generation; D028321:Plant Preparations; D000069470:Venlafaxine Hydrochloride
keywords: Celery root; St John’s worth; bipolar disorder; mania; venlafaxine