Open main menu

Psychiatrienet β

Hypericum-agomelatine

Hypericum
Type Antidepressant
Group other
links
EMEA 10130408en
PubMed Hypericum
Kompas (Dutch) hypericum extract
Wikipedia St John's wort
Agomelatine
Type Antidepressant
Group other
links
ATC-code N06AX22
EMEA valdoxan
PubChem 82148
PubMed Agomelatine
Kompas (Dutch) Agomelatine
Wikipedia Agomelatine

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

Nietinrijdenbord.png 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.
Eenrichtingbord.png Start agomelatine
  • Day 1: simultaneously start administration of agomelatine in a dosage of 25 mg/day.[3]
  • If necessary, increase dosage of agomelatine to 50 mg/day.
Infobord.png More information
  • Hypericum induces CYP1A2, which metabolizes agomelatine
  • 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]
  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. McAllister-Williams RH et al. The use of antidepressants in clinical practice: focus on agomelatine. Hum Psychopharmacol. 2010 Mar 1;25(2):95-102
  4. 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.