Hypericum-fenelzine

Hypericum
Type Antidepressant
Group other
links
EMEA 10130408en
PubMed Hypericum
Kompas (Dutch) hypericum extract
Wikipedia St John's wort
Fenelzine
Type Antidepressant
Group MAO-I
links
PubMed Fenelzine
Kompas (Dutch) Fenelzine
Wikipedia Fenelzine

Switch medication from hypericum to fenelzine[1][2]

Nietinrijdenbord.png Stop hypericum
  • Day 1: Decrease the original dose with about 25% every 3 days.
  • Stop and wait 7 days for washout
Eenrichtingbord.png Start fenelzine
  • a wash-out period of 7 days is necessary.
  • Start fenelzine in a low dosage of 15 mg, 3 times a day, for two weeks.
  • After this two weeks the dosage of fenelzine can be increased.
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.[3]
  • No severe interactions are known.


  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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