[Suicidal and aggressive thoughts as a result of taking a Hypericum preparation (St. John's wort)].

A 51-year-old woman presented at the internal medical outpatients' clinic complaining of fatigue. She had been having frightening suicidal and homicidal thoughts for about 9 months prior to coming to the clinic. Physical examination and extensive laboratory examination revealed no abnormalities. She had been taking vitamin C and a herbal extract of St. John's wort. She was asked to stop taking this herbal extract and her suicidal and homicidal thoughts disappeared within about 3 weeks. She then recalled having used the preparation for some time 3 years earlier, which had given her similar psychiatric symptoms. At that time these symptoms had also disappeared after discontinuation of the preparation. This case illustrates that it is very important to ask about the use of non-regular medication during history taking.