Hypericum-mirtazapine

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Hypericum
Type Antidepressant
Group other
links
EMEA 10130408en
PubMed Hypericum
Kompas (Dutch) hypericum extract
Wikipedia St John's wort
Mirtazapine
Type Antidepressant
Group other
links
Medscape Mirtazapine
PubChem 4205
PubMed Mirtazapine
Kompas (Dutch) Mirtazapine
Wikipedia Mirtazapine

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

Nietinrijdenbord.png Stop hypericum
  • Administration of hypericum can be stopped abruptly.
Eenrichtingbord.png Start mirtazapine
  • Day 1-7: a wash-out period of one week is necessary.
  • Day 8: start administration of mirtazapine in a dosage of 15 mg/day.
  • Day 15: increase dosage of mirtazapine to 30 mg/day.
  • If necessary, increase dosage of mirtazapine further.
Infobord.png More information
  • Occurence of the serotonin syndrome is theoretically possible.
  • Hypericum slows the metabolism of citalopram/escitalopram via CYP3A4. This effect may persist up to two weeks after stopping hypericum, so caution is necessary.
  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.
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