Switch medication from tranylcypromine to hypericum.
- Day 1-14: decrease the original dose with about 25% every 3 days.
- Day 15: Start and increase the dose with about 25% of the target dose every 3 days or 50% per week.
- After the last dose of tranylcypromine it takes about 14 days to restore the activity of the MAO enzymes
- Imai H, Kotegawa T, Tsutsumi K, Morimoto T, Eshima N, Nakano S, Ohashi K. The recovery time-course of CYP3A after induction by St John's wort administration. Br J Clin Pharmacol. 2008 May;65(5):701-7.
- Wurglics M, Schubert-Zsilavecz M. Hypericum perforatum: a 'modern' herbal antidepressant: pharmacokinetics of active ingredients. Clin Pharmacokinet. 2006;45(5):449-68.
- KNMP; Informatorium Medicamentorum 2015; Monografie "tranylcypromine" (Dutch)
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