Switch medication from mirtazapine to hypericum.
- Before day 1: Gradually reduce dosage of mirtazapine to a maximum of 30 mg/day, when this dosage is > 30 mg/day.
- Day 1: Reduce dosage of mirtazapine to 15 mg/day.
- Day 8: Stop administration of mirtazapine.
- Day 8-14: a wash-out period of one week is necessary.
- Day 15: start administration of hypericum in a dosage of 300 mg three times a day (900 mg/day).
- Occurrence of the serotonin syndrome is possible without wash-out period.
- Hypericum slows the metabolism of mirtazapine via CYP3A4.
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