Hypericum-venlafaxine

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Hypericum
Type Antidepressant
Group other
links
EMEA 10130408en
PubMed Hypericum
Kompas (Dutch) hypericum extract
Wikipedia St John's wort
Venlafaxine
Type Antidepressant
Group SNRI
links
Medscape Venlafaxine
PubChem 5656
PubMed Venlafaxine
Kompas (Dutch) Venlafaxine
Wikipedia Venlafaxine

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

Nietinrijdenbord.png Stop hypericum
  • Day 1-14: Gradually decrease the dosage of hypericum.
  • Day 15: stop administration of hypericum.
Eenrichtingbord.png Start venlafaxine
  • Day 15-30: a wash-out period of at least two weeks is necessary.
  • Day 31: start venlafaxine 37,5 mg or 75 mg (slow release)/day.
Letopbord.png Cave
  • Occurrence of the serotonin syndrome is possible without wash-out period.
Infobord.png 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]
  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.
  3. 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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