Mirtazapine-hypericum

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Mirtazapine
Type Antidepressant
Group other
links
Medscape Mirtazapine
PubChem 4205
PubMed Mirtazapine
Kompas (Dutch) Mirtazapine
Wikipedia Mirtazapine
Hypericum
Type Antidepressant
Group other
links
EMEA 10130408en
PubMed Hypericum
Kompas (Dutch) hypericum extract
Wikipedia St John's wort

Switch medication from mirtazapine to hypericum.[1] [2]

Nietinrijdenbord.png Stop mirtazapine
  • Before day 1: Gradually reduce dosage of mirtazapine to a maximum of 30 mg/day, when this dosage is > 30 mg/day.
  • Day 1: Reduce dosage of mirtazapine to 15 mg/day.
  • Day 8: Stop administration of mirtazapine.
Eenrichtingbord.png Start hypericum
  • Day 8-14: a wash-out period of one week is necessary.
  • Day 15: start administration of hypericum in a dosage of 300 mg three times a day (900 mg/day).
Infobord.png More information
  • Occurrence of the serotonin syndrome is possible without wash-out period.
  • Hypericum slows the metabolism of mirtazapine via CYP3A4.
  1. 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
  2. Stahl, S. M. (2013). Stahl's essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). Cambridge University Press.
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