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Hypericum-paroxetine

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Hypericum
Type Antidepressant
Group other
links
EMEA 10130408en
PubMed Hypericum
Kompas (Dutch) hypericum extract
Wikipedia St John's wort
paroxetine
Type Antidepressant
Group SSRI
links
Medscape paroxetine
PubChem 43815
PubMed paroxetine
Kompas (Dutch) paroxetine
Wikipedia paroxetine

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

Nietinrijdenbord.png Stop hypericum
  • Day 1-14:Gradually decrease the dosage of hypericum.
  • Day 15: stop administration of hypericum.
Eenrichtingbord.png Start paroxetine
  • Day 15-30: a wash-out period of at least two weeks is necessary.
  • Day 31: start paroxetine 20 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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