Paroxetine-hypericum

paroxetine
Type Antidepressant
Group SSRI
links
Medscape paroxetine
PubChem 43815
PubMed paroxetine
Kompas (Dutch) paroxetine
Wikipedia paroxetine
Hypericum
Type Antidepressant
Group other
links
EMEA 10130408en
PubMed Hypericum
Kompas (Dutch) hypericum extract
Wikipedia St John's wort

Switch medication from paroxetine to hypericum.

Nietinrijdenbord.png Stop paroxetine
  • Day -7: reduce dosage of paroxetine to 20 mg/day, if this dosage is > 20 mg/day.
  • Day 0: dosage of paroxetine is 20 mg/day.
  • Day 1: reduce dosage of paroxetine to 10 mg/day.
  • Day 8: reduce dosage of paroxetine to 5 mg/day.
  • Day 15: stop administration of paroxetine.
Eenrichtingbord.png Start hypericum
  • Day 15-22: a wash-out period of about 1 week is necessary.[1][2][3][4]
  • Day 23: start administration of hypericum in a dosage of 300 mg three times a day (900 mg/day).
Letopbord.png Cave
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.[7]
  • The T1/2 of hypericum is 19 - 37 hour.[4]
  1. ↑ 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.
  2. ↑ Wurglics M, Schubert-Zsilavecz M. Hypericum perforatum: a 'modern' herbal antidepressant: pharmacokinetics of active ingredients. Clin Pharmacokinet. 2006;45(5):449-68.
  3. ↑ Derijks HJ, Janknegt R, Heerdink ER, De Koning FH, Krekels MM, Looij BJ, Egberts AC. Influence of antidepressant use on glycemic control in patients with diabetes mellitus: an open-label comparative study. J Clin Psychopharmacol. 2009 Aug;29(4):405-8.
  4. ↑ 4.04.1 KNMP; Informatorium Medicamentorum 2015; Monografie "paroxetine" (Dutch) Cite error: Invalid <ref> tag; name "informatorium" defined multiple times with different content
  5. ↑ F. Borelli et al.Herb-drug interactions with St John's wort (Hypericum perforatum): an update on clinical observations. AAPS J. 2009 Dec;11(4):710-27
  6. ↑ Izzo AA. Drug interactions with St John's wort (Hypericum perforatum): a review of the clinical evidence. Int J Clin Pharmacol Ther. 2004 Mar;42(3):139-48
  7. ↑ 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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