Dosulepine-hypericum
From Psychiatrienet
| ||||||||||||||||||||||||||||||||||||
| ||||||||||||||||||||||||||||||||||||
Switch medication from dosulepine to hypericum.[1] [2]
Stop dosulepine - Before day 1: gradually reduce dosage of dosulepine to a maximum of 75 mg/day, when this dosage is > 75 mg/day.
- Day 1: reduce dosage of dosulepine to 50 mg/day.
- Day 8: reduce dosage of dosulepine to 25 mg/day.
- Day 15: stop administration of dosulepine.
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).
Cave- Occurrence of the serotonin syndrome is theoretically possible without wash-out period.
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]
- This switch is currently being reviewed.
- ↑ 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.
- ↑ Wurglics M, Schubert-Zsilavecz M.Hypericum perforatum: a 'modern' herbal antidepressant: pharmacokinetics of active ingredients. Clin Pharmacokinet. 2006;45(5):449-68.
The editors of psychiatrienet.nl take the greatest care to provide up-to-date and accurate information on this site. Nevertheless, mistakes and omissions cannot be entirely excluded. No rights devolve from the information provided. The editors and other providers of information to this site accept no responsibility for the content of this site or for the information provided therein; neither do they accept responsibility for possible damages which may derive from the use of the information on this site or from the linked sites. The editorial board accepts no responsibility for the content of the (linked) sites, for access to them, or for the products and services on these sites, nor for the occurrence of errors, viruses, and/or disruptions in service.
