Difference between revisions of "Hypericum-fluvoxamine"
From Psychiatrienet
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| to = fluvoxamine | | to = fluvoxamine | ||
| stop = | | stop = | ||
| − | * '''Day 1-14:''' | + | * '''Day 1-14:''' gradually decrease the dosage of hypericum. |
* '''Day 15:''' stop administration of hypericum. | * '''Day 15:''' stop administration of hypericum. | ||
| start = | | start = | ||
| Line 9: | Line 9: | ||
* '''Day 31:''' start fluvoxamine 50 mg/day. | * '''Day 31:''' start fluvoxamine 50 mg/day. | ||
| caveat = | | caveat = | ||
| − | * Occurrence of the serotonin syndrome is possible without wash-out period. | + | * Occurrence of the serotonin syndrome is possible without wash-out period.{{Lit-SSRI-Hypericum}} {{Lit-SSRI-Hypericum2}} |
| info = | | info = | ||
{{HypericumInfo}} | {{HypericumInfo}} | ||
}} | }} | ||
Revision as of 15:33, 12 March 2010
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Switch medication from hypericum to fluvoxamine.[1] [2]
Stop hypericum - Day 1-14: gradually decrease the dosage of hypericum.
- Day 15: stop administration of hypericum.
Start fluvoxamine- Day 15-30: a wash-out period of at least two weeks is necessary.
- Day 31: start fluvoxamine 50 mg/day.
Cave
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.[5]
- ↑ 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.
- ↑ F. Borelli et al.Herb-drug interactions with St John's wort (Hypericum perforatum): an update on clinical observations. AAPS J. 2009 Dec;11(4):710-27
- ↑ Izzo AA. Drug interactions with St John's wort (Hypericum perforatum): a review of the clinical evidence. Int J Clin Pharmacol Ther. 2004 Mar;42(3):139-48
- ↑ 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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