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Yohimbine is a potent selective α2R antagonist with weaker α1R antagonist activity that blocks the presynaptic feedback inhibition of noradrenaline release, prolonging the excitatory effects of noradrenaline at postsynaptic α1R and β-receptors [237,238]. In fact, ginseng toxicity mainly comes from drug interactions with cytochromes P450 (CYPs) CYP3A4 and CYP2D6 inhibitors and serotoninergic drugs, intensifying sedative effects or inducing cognitive disorders or a serotonin syndrome [229,230,231]. More interestingly, several cases of manic-like effects, such as confusion, agitation, irritation, nervousness, anxiety, and bizarre behavior, without history of psychiatric disorder, were reported following ginseng use [77,78,81,85,87,88,90,228]. In fact, most clinical studies with ginseng or ginsenosides reported no psychiatric or neurological side effects or statistically insignificant effects compared to placebo, and were not included in Table 1 [223,224,225,226,227]. 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