Difference between revisions of "Hypericum-amitriptyline"
From Psychiatrienet
| (8 intermediate revisions by 2 users not shown) | |||
| Line 3: | Line 3: | ||
| to = amitriptyline | | to = amitriptyline | ||
| stop = | | stop = | ||
| − | + | {{Stophyp}} | |
| − | |||
| start = | | start = | ||
| − | + | {{TCAincrease25p3d}} | |
| − | + | ||
| − | + | ||
| − | |||
| info = | | info = | ||
| + | {{TCAplasmalevelmonitoring}} | ||
| + | * The ratio of amitriptyline/nortriptyline could change because of CPY2C19 induction. Sum plasmalevels are not likely to change because CYP2D6 is barely affected. | ||
| + | {{caveSS}} | ||
{{HypericumInfo}} | {{HypericumInfo}} | ||
| − | |||
}} | }} | ||
Latest revision as of 15:09, 4 August 2023
| ||||||||||||||||||||||||||||
| ||||||||||||||||||||||||||||
Switch medication from hypericum to amitriptyline.[1] [2]
Stop hypericum - Day 1: Stop hypericum.
- The administration of hypericum can be stopped abruptly. Induction of CYP enzymes will last at least 14 more days.
Start amitriptyline- Day 1: Increase with about 25% of target dose per 3 days.
More information- Plasma monitoring for TCA's is advisable, because of plasma-reponse relations, genetic polymorphism and under or overdosing.[3]
- The ratio of amitriptyline/nortriptyline could change because of CPY2C19 induction. Sum plasmalevels are not likely to change because CYP2D6 is barely affected.
- Occurrence of the serotonin syndrome is possible without wash-out period.
- Hypericum induces enzymes of the CYP P-450 type and P-gp type.
- Hypericum might have MAO-inhibiting and/or COMT-inhibiting properties.
- Many studies reported that hypericin is the main source of pharmacological effects of hypericum. However the IC50 of hypericin to inhibit MAO A and MAO B is 100- to 1000-fold higher than accessible Cmax values of hypericin after oral administration of hypericum.[4]
- ↑ Switches are based on literature references on this page and expert opinions of the authors. The authors have used pharmacokinetic and receptor affinity properties to determine the switch schedules
- ↑ Stahl, S. M. (2013). Stahl's essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). Cambridge University Press.
- ↑ (dutch) monografie.org tricyclische-antidepressiva
- ↑ Wurglics M, Schubert-Zsilavecz M.Hypericum perforatum: a 'modern' herbal antidepressant: pharmacokinetics of active ingredients. Clin Pharmacokinet. 2006;45(5):449-68.
The editors of psychiatrienet.nl take the greatest care to provide up-to-date and accurate information on this site. Nevertheless, mistakes and omissions cannot be entirely excluded. No rights devolve from the information provided. The editors and other providers of information to this site accept no responsibility for the content of this site or for the information provided therein; neither do they accept responsibility for possible damages which may derive from the use of the information on this site or from the linked sites. The editorial board accepts no responsibility for the content of the (linked) sites, for access to them, or for the products and services on these sites, nor for the occurrence of errors, viruses, and/or disruptions in service.
