Published online by Cambridge University Press: 13 June 2014
A case of affective psychosis and cognitive impairment is described. The patient had a history of cerebrovascular disease and had been ingesting large quantities of a complex herbal tonic prior to presentation. Diagnostic issues are discussed. Relevant literature on cerebrovascular disease and herbal remedies is reviewed. We propose a stress-diathesis model to account for this patient's illness and we advise caution in the use of complementary therapies in patients with compromised cerebrovascular status. Appropriate practice guidelines are outlined.