Difference between revisions of "Hypericum-fluoxetine"
From Psychiatrienet
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| to = fluoxetine | | to = fluoxetine | ||
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| − | * | + | * '''Day 1-14:''' gradually decrease the dosage of hypericum. |
| − | | start = | + | * '''Day 15:''' stop administration of hypericum. |
| − | * '''Day | + | | start = |
| − | * '''Day | + | * '''Day 15-22:''' a wash-out period of at least one week is necessary.<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|fluoxetine}}</ref> |
| − | * | + | * '''Day 23:''' start fluoxetine at 100% of the target dose. |
| − | | info = | + | * ''' After day 23: ''' gradually increase dose as necessary |
| − | * | + | | info = |
| + | * Safe target dose fluoxetine = 20 mg | ||
| + | {{HypericumInfo}} | ||
| + | {{caveSS}}{{Lit-SSRI-Hypericum}} {{Lit-SSRI-Hypericum2}} | ||
}} | }} | ||
Latest revision as of 12:04, 8 March 2024
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Switch medication from hypericum to fluoxetine.[1] [2]
Stop hypericum - Day 1-14: gradually decrease the dosage of hypericum.
- Day 15: stop administration of hypericum.
Start fluoxetine- Day 15-22: a wash-out period of at least one week is necessary.[3][4][5][6]
- Day 23: start fluoxetine at 100% of the target dose.
- After day 23: gradually increase dose as necessary
More information- Safe target dose fluoxetine = 20 mg
- 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.[7]
- Occurrence of the serotonin syndrome is possible without wash-out period.[8] [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 "fluoxetine" (Dutch)
- ↑ Wurglics M, Schubert-Zsilavecz M.Hypericum perforatum: a 'modern' herbal antidepressant: pharmacokinetics of active ingredients. Clin Pharmacokinet. 2006;45(5):449-68.
- ↑ 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
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