J Korean Med Assoc Search

CLOSE


J Korean Med Assoc > Volume 48(4); 2005 > Article
Choi: Neurotoxicity of Herbal Medicine

Abstract

Herbal medicines have been used for thousands of years, and herb preparations are commercially available for the folk remedies or for the promotion of health. In contrast to chemical drugs, herbs are regarded to be non-toxic and safe, because of their natural origin. But accumulating clinical data claim the toxicity of herbal medicine. They can cause adverse effects through ① toxicity of the herb itself or bioactivation of its metabolites, ② interaction with prescribed drugs, and ③ heavy metals contaminated in the herbal products. Recent studies have disclosed various neurologic side effects of herbal medicine, including cerebrovascular accident, convulsion, encephalopathy, hallunication, and psychosis. In addition to, some herbs interact with the neurologic therapeutic drugs, such as anticoagulants and antiepileptic drugs, leading to failure to control the patients' diseases. Also, there is growing evidence that herbal medicine products contain potentially harmful levels of lead, mercury and arsenic, all of which have neurotoxicity. Systematic validation of the potency and toxicity of herbal medicines as well as screening of toxic heavy metal content should be warranted.

References

1. Deng JF. Clinical and laboratory investigations in herbal poisonings. Toxicology 2002;181-2:571–576.

2. Haller CA, Benowitz NL. Adverse cardiovascular and central nervous system event associated with dietary supplements containing ephedra alkaloid. N Engl J Med 2000;343:1833–1838.

3. Miller LG. Herbal medicinals. Arch Intern Med 1998;158:2200–2211.

6. Wang XP, Yang RM. Movement disorders possibly induced by traditional Chinese herb. Eur Neurol 2003;50:153–159.

7. Sigel RK. Ginseng abuse syndrome. JAMA 1979;241:1614–1615.

9. Balikova M. Collective poisoning with hallucinogenous herbal tea. Forensic Sci Inter 2002;128:50–52.

10. Boerth JM, Caley CF. Possible case of mania associated with ma-huang. Pharmacotherapy 2003;23:380–383.

11. Almeida JC, Grimsley EW. Coma from the health food store: interaction between kava and alprazolam. Ann Intern Med 1996;125:940–941.

12. Parkman CA. Another FDA warning: Kava supplements. Case Manager 2002;13:26–28.

13. Shintani S, Murase H, Tsukagoshi H. Glycyrrhizin(licorice)-induced hypokalemic myopathy. Eur Neurol 1992;32:44–51.

14. Zhou S, Koh HL, Gao Y, Gong A, Lee EJD. Herbsl bioactivation: The good, the bad and the ugly. Life Sci 2004;74:935–968.

15. Fugh-Berman A. Herb-drug interaction. Lancet 2000;355:134–138.

16. Heck AM, DeWitt BA, Lukes AL. Potential interactions between alternative therapies and warfarin. Am J Health-Syst Pharm 2000;57:1221–1230.

17. Deahl M. Betel nut-induced extrapyramidal syndrome: an unusual drug interaction. Mov Disord 1989;4:330–333.

18. Lantz MS, Buchalter E, Giambanco V. St. John's wort and antidepressant drug interaction in the elderly. J Geriat Psychiat Neurol 1999;12:7–10.

19. Huang WF, Wen KC, Hsiao ML. Adulteration by synthetic therapeutic substances of traditional Chinese medicines in Taiwan. J Clin Pharmacol 1997;37:344–350.

20. Saper RB, Kales SN, Paquin J, Burns MJ, Eisenberg DM, Davis RB, et al. Heavy metal content of ayurvedic herbal medicine product. JAMA 2004;292:2868–2873.

21. Ernst E. Toxic heavy metals and undeclared drugs in Asian herbal medicine. Trend Pharmacol Sci 2002;23:136–139.

22. Koh HL, Woo SO. Chinese propertietary medicines in Singapore. Regulatory control of toxic heavy metals and undeclared drugs. Drug Safe 2000;23:351–362.

23. Parry GJ. In: Aminoff MJ, editor. Neurological complications of toxin exposure in the workplace. Neurology and general medicine 2001;3rd ed. New York: Churchill Livingstone. 654–657.

24. Eisenberg DM, Kessler RC, Foster C, Norlock FE, Calkins DR, Delbanco TL. Unconventional medicine in the United States: prevalence, costs, and patterns of use. N Engl J Med 1993;328:246–252.



ABOUT
BROWSE ARTICLES
EDITORIAL POLICY
FOR CONTRIBUTORS
Editorial Office
37 Ichon-ro 46-gil, Yongsan-gu, Seoul 04427, Korea
Tel: +82-2-6350-6651    Fax: +82-2-792-5208    E-mail: office@jkma.org                

Copyright © 2026 by Korean Medical Association.

Developed in M2PI

Close layer
prev next