J Psychopharmacol. 2000 Mar;14(1):84-6.

Mania in a patient receiving testosterone replacement postorchidectomy taking St John's wort and sertraline.

Barbenel DM, Yusufi B, O'Shea D, Bench CJ.

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Division of Neuroscience and Psychological Medicine, Imperial College School of Medicine, London, UK.

Abstract

We describe the case of a patient who developed depression following bilateral orchidectomy for cryptorchidism. He was treated with a conventional selective serotonin reuptake inhibitor antidepressant, but continued to take St John's wort (hypericum) against medical advice. He subsequently developed a manic episode. We discuss postulated modes of action of St John's wort and the possible aetiological importance of testosterone replacement and abnormal gonadotrophin levels in this case.

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