Switch medication from hypericum to doxepin.[2]
[3]
Stop hypericum
- Day 1-14:Gradually decrease the dosage of hypericum.
- Day 15: stop administration of hypericum.
Start doxepin
- Day 15-30: a wash-out period of at least two weeks is necessary.
- Day 31: start doxepin 50 mg/day.
More information
- Occurrence of the serotonin syndrome is possible without wash-out period.
- Hypericum induces enzymes of the CYP P-450 type and P-gp.
- Hypericum probably has MAO-inhibiting properties.
- ↑ 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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Stop hypericum 
Start doxepin
More information