Difference between revisions of "Maprotiline-hypericum"
From Psychiatrienet
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* '''Day 15-22:''' a wash-out period of one week is necessary. | * '''Day 15-22:''' a wash-out period of one week is necessary. | ||
| − | * '''Day 23:''' start administration of hypericum | + | * '''Day 23:''' start administration of hypericum. |
| caveat = | | caveat = | ||
* Occurrence of the serotonin syndrome is possible without wash-out period. | * Occurrence of the serotonin syndrome is possible without wash-out period. | ||
Revision as of 16:28, 17 July 2009
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Switch medication from maprotiline to hypericum.[1] [2]
Stop maprotiline - Before day 0: gradually reduce dosage of maprotiline to a maximum of 75 mg/day, when this dosage is > 75 mg/day.
- Day 1: reduce dosage of maprotiline to 50 mg/day.
- Day 8: reduce dosage of maprotiline to 25 mg/day.
- Day 15: stop administration of maprotiline.
Start hypericum- Day 15-22: a wash-out period of one week is necessary.
- Day 23: start administration of hypericum.
Cave- Occurrence of the serotonin syndrome is possible without wash-out 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.[3]
- ↑ 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.
- ↑ 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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