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Doxepine-hypericum

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Doxepin
Type antidepressant
Group TCA
links
ATC-code N06AA12
Medscape Doxepin
PubChem 3158
PubMed Doxepin
Drugs.com doxepin
Kompas (Dutch) Doxepin
Wikipedia Doxepin
Hypericum
Type Antidepressant
Group other
links
EMEA 10130408en
PubMed Hypericum
Kompas (Dutch) hypericum extract
Wikipedia St John's wort

Switch medication from doxepin to hypericum.[2] [3]

Nietinrijdenbord.png 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.
Eenrichtingbord.png 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).
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.[4]
  1. ↑ 1.0 1.1 1.2 1.3 1.4 KNMP; Informatorium Medicamentorum 2023; Monografie "doxepine" (Dutch)
  2. ↑ 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
  3. ↑ Stahl, S. M. (2013). Stahl's essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). Cambridge University Press.
  4. ↑ 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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