Difference between revisions of "Hypericum-dosulepine"

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* '''Day 15-30:''' a wash-out period of at least two weeks is necessary.  
 
* '''Day 15-30:''' a wash-out period of at least two weeks is necessary.  
 
* '''Day 31:''' start dosulepine 25 mg/day.
 
* '''Day 31:''' start dosulepine 25 mg/day.
| info =  
+
| caveat =  
 
* Occurrence of the serotonin syndrome is possible without wash-out period.
 
* Occurrence of the serotonin syndrome is possible without wash-out period.
* Hypericum induces enzymes of the CYP P-450 type and P-gp.
+
| info =
* Hypericum probably has MAO-inhibiting properties.}}
+
{{HypericumInfo}}
 +
}}

Revision as of 10:42, 15 July 2009

Hypericum
Type Antidepressant
Group other
links
EMEA 10130408en
PubMed Hypericum
Kompas (Dutch) hypericum extract
Wikipedia St John's wort
dosulepin
Type antidepressant
Group TCA
links
ATC-code N06AA16
PubChem 13473
PubMed dosulepin
Kompas (Dutch) dosulepin
Wikipedia dosulepin

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

Nietinrijdenbord.png Stop hypericum
  • Day 1-14:Gradually decrease the dosage of hypericum.
  • Day 15: stop administration of hypericum.
Eenrichtingbord.png Start dosulepine
  • Day 15-30: a wash-out period of at least two weeks is necessary.
  • Day 31: start dosulepine 25 mg/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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