Doxepine-hypericum
From Psychiatrienet
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Switch medication from doxepin to hypericum.[2] [3]
Stop doxepin - Before day 0: gradually reduce dosage of doxepin to a maximum of 100 mg/day, when this dosage is > 100 mg/day.
- Day 1: reduce dosage of doxepin to 50 mg/day.
- Day 8: reduce dosage of doxepin to 25 mg/day.
- Day 15: stop administration of doxepin.
Start hypericum- Day 15-22: a wash-out period of one week is necessary.
- Day 23: start administration of hypericum in a dosage of 300 mg three times a day (900 mg/day).
More information- Occurrence of serotonin syndrome is theoretically possible, so caution is necessary.
- Hypericum slows the metabolism of doxepin via CYP3A4.
- ↑ 1.0 1.1 1.2 1.3 1.4 KNMP; Informatorium Medicamentorum 2023; Monografie "doxepine" (Dutch)
- ↑ 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.
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