Which herb is contraindicated in pregnancy, breastfeeding, and bipolar disorder?

• A. Sanguinaria canadensis
• B. Sambucus nigra
• C. Rubus idaeus
• D. Rhodiola rosea

Answer: (D)

Rhodiola rosea is avoided in pregnancy, breastfeeding, and bipolar disorder because its CNS-stimulating, mood-modulating effects can destabilize mood and are not supported by sufficient safety data for these states. As an adaptogen, it can elevate energy and influence monoamines, which in bipolar disorder can trigger manic or hypomanic episodes. In pregnancy and lactation, the lack of solid safety data plus potential stimulating effects means there could be risks to the fetus or infant, so it’s contraindicated. Other herbs listed have different safety profiles in these contexts: Sanguinaria canadensis is highly toxic and not advised in pregnancy; Sambucus nigra (elderberry) is generally considered safe; Rubus idaeus (raspberry leaf) is often used later in pregnancy to support uterine tone, with its own cautions.