Eleutherococcus pharmacy and adverse effects
by Paul Bergner
Medical Herbalism 11(4):16,18
Eleutherococcus (Acanthopanax) senticosus, or Siberian ginseng, is generally considered to be a mild herb, with little potential to cause side effects. Here we report an apparent manic attack induced by an overdose of a concentrated extract of the plant.
Although mention of eleutherococcus is made in classical Chinese medical literature, the use of the root as a tonic and adaptogen was only clearly elucidated by Soviet researchers during the twentieth century. The Russian Pharmacopoeia form of the product is a 1:1 extract in 30% alcohol, with the daily dose of 2-15 ml. Most Western products use either the powder, or a standard hydroalcoholic extracts made in more than 50% alcohol, and ranging from 1:5 to 1:2 in extract strength, and in doses of less than 1 ml to perhaps 3 ml per day. Thus the typical Western forms are significantly weaker than the Russian product on which most scientific research has been done, and it is these weaker forms that have given the herb it reputation as a mild tonic with little potential for side effects.
A 21 year-old male read in an herbal text that a person could take as much eleutherococcus as they wanted. The product he had, however, was made according to Russian Pharmacopoeia standard, and then further concentrated to a 2:1 strength. He took 10 ml of this at 10 a.m., already exceeding the upper recommended dose which would be 7.5 ml. At 1 PM he took a double espresso. Then at 5PM he took another 5 ml of the eleutherococcus, now doubling the upper daily dose. He then reported the following symptoms and incidents over the next 5-6 hours.
“Enlightened”; “euphoric”; Trimmed beard, botched it, then had to shave it. “Giddy”; “Manic”; Was screaming while riding bike in public. Screaming in room and yelling. Laughing hysterically in room. “Nothing wrong, it just feels good to yell.” “Nothing particularly funny, it just feels good to laugh.”
By 9 PM “trying not to meet anyone he knew.” “Anxious in public”; “Giggling fits for no apparent reason, nothing funny”; “Body feels stressed – tension in muscles – trembling”; “As if almost got hit by a car, except sustained”; “Like caffeine, but more ingrained”;
“I took amphetamines a few times in high school. I liked that, I don’t like this.”
Practitioner took patient on 1 ½ mile walk. Now regrets shaving beard “Why did I do it?”
Intense craving for ice cream despite
violent dairy sensitivity. “Sugar would do.” Ate nuts and fried
plantain. Improved some with food, still anxious.
Signature: Decoction of equal parts of hypericum, passiflora, scutellaria, melissa, one handful of each in qt of water. Decoct for twenty minutes. Drank the entire quart over an hour. After 30 minutes, sleepy and went to bed.
Patient denies previous history of
bipolar disorder. At least one relative has had diagnosis of bipolar
disorder. Subject experienced two episodes of suicidal depression over
next 4 weeks, underwent brief psychotherapy, then mood apparently
steady for four months.