Difference between revisions of "Amitriptyline-hypericum"
From Psychiatrienet
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* '''Day 1:''' reduce dosage of amitriptyline to 25 mg/day. | * '''Day 1:''' reduce dosage of amitriptyline to 25 mg/day. | ||
* '''Day 8:''' stop administration of amitriptyline. | * '''Day 8:''' stop administration of amitriptyline. | ||
| − | | start = * '''Day 8:''' start administration of hypericum in a dosage of 300 mg three times a day (900 mg/day). | + | | start = |
| + | * '''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). | ||
| info = | | info = | ||
| caveat = | | caveat = | ||
Revision as of 13:11, 15 August 2011
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Switch medication from amitriptyline to hypericum.[1] [2]
Stop amitriptyline - Before day 1: gradually reduce dosage of amitriptyline to a maximum of 50 mg/day, when this dosage is > 50 mg/day.
- Day 1: reduce dosage of amitriptyline to 25 mg/day.
- Day 8: stop administration of amitriptyline.
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).
Cave- Occurrence of the serotonin syndrome is possible without wash-out period.
More information- 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.[3]
- ↑ 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.
- ↑ Wurglics M, Schubert-Zsilavecz M.Hypericum perforatum: a 'modern' herbal antidepressant: pharmacokinetics of active ingredients. Clin Pharmacokinet. 2006;45(5):449-68.
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