Switch medication from imipramine to hypericum.[1]
[2]
Stop imipramine
- Before day 0: gradually reduce dosage of imipramine to a maximum of 75 mg/day, when this dosage is > 75 mg/day.
- Day 1: reduce dosage of imipramine to 50 mg/day.
- Day 8: reduce dosage of imipramine to 25 mg/day.
- Day 15: stop administration of imipramine.
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 imipramine via CYP3A4.
- ↑ 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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Stop imipramine 
Start hypericum
More information