Dosulepine-hypericum

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dosulepin
Type antidepressant
Group TCA
links
ATC-code N06AA16
PubChem 13473
PubMed dosulepin
Kompas (Dutch) dosulepin
Wikipedia dosulepin
Hypericum
Type Antidepressant
Group other
links
EMEA 10130408en
PubMed Hypericum
Kompas (Dutch) hypericum extract
Wikipedia St John's wort

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

Nietinrijdenbord.png 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.
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 theoretically 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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