Difference between revisions of "Citalopram-hypericum"
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| − | * '''Day | + | * '''Day 16:''' start administration of hypericum in a dosage of 300 mg three times a day (900 mg/day).<ref>{{Pubmed|18294328|Imai H, Kotegawa T, Tsutsumi K, Morimoto T, Eshima N, Nakano S, Ohashi K. The recovery time-course of CYP3A after induction by St John's wort administration. Br J Clin Pharmacol. 2008 May;65(5):701-7.}}</ref><ref>{{Pubmed|16640452|Wurglics M, Schubert-Zsilavecz M. Hypericum perforatum: a 'modern' herbal antidepressant: pharmacokinetics of active ingredients. Clin Pharmacokinet. 2006;45(5):449-68.}}</ref><ref>{{Pubmed|19593191|Derijks HJ, Janknegt R, Heerdink ER, De Koning FH, Krekels MM, Looij BJ, Egberts AC. Influence of antidepressant use on glycemic control in patients with diabetes mellitus: an open-label comparative study. J Clin Psychopharmacol. 2009 Aug;29(4):405-8.}}</ref><ref name="informatorium">{{KNMP|citalopram}}</ref> {{Lit-SSRI-Hypericum}} {{Lit-SSRI-Hypericum2}} |
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Latest revision as of 12:26, 21 October 2015
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Switch medication from citalopram to hypericum.[1] [2]
Stop citalopram - Day 1: reduce dosage of citalopram to a maximum of 20 mg/day
- Day 8: reduce dosage of citalopram to 10 mg/day
- Day 15: stop citalopram
Start hypericum- Day 16: start administration of hypericum in a dosage of 300 mg three times a day (900 mg/day).[3][4][5][6] [7] [8]
Cave- The reduction of the SSRI doses in 7-14 days could cause emotional instability, headache and flu-like symptoms. One could extend this 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.[9]
- ↑ 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.
- ↑ Imai H, Kotegawa T, Tsutsumi K, Morimoto T, Eshima N, Nakano S, Ohashi K. The recovery time-course of CYP3A after induction by St John's wort administration. Br J Clin Pharmacol. 2008 May;65(5):701-7.
- ↑ Wurglics M, Schubert-Zsilavecz M. Hypericum perforatum: a 'modern' herbal antidepressant: pharmacokinetics of active ingredients. Clin Pharmacokinet. 2006;45(5):449-68.
- ↑ Derijks HJ, Janknegt R, Heerdink ER, De Koning FH, Krekels MM, Looij BJ, Egberts AC. Influence of antidepressant use on glycemic control in patients with diabetes mellitus: an open-label comparative study. J Clin Psychopharmacol. 2009 Aug;29(4):405-8.
- ↑ KNMP; Informatorium Medicamentorum 2023; Monografie "citalopram" (Dutch)
- ↑ 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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