Document Detail


Interaction of St John's wort (Hypericum perforatum) with clozapine.
MedLine Citation:
PMID:  22113252     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
St John's wort (Hypericum perforatum) is notorious for its ability to induce the enzymes of the P450 system. Especially, it induces CYP1A2 and CYP3A4, enzymes that are closely involved in the metabolism of clozapine. We present a patient with schizophrenia, who was stable on a fixed dose with stable plasma level of clozapine, and who deteriorated after she started self-medicating with St John's wort. The reduced plasma clozapine level and the psychiatric condition normalized after the withdrawal of St John's wort. It is possible that, beside the induction of P450-enzymes, the induction of P-glycoprotein by St John's wort aggravated psychiatric deterioration of the patient. Physicians should be alert to patients self-medicating with over-the-counter medicines, especially when these medicines can lower clozapine concentrations below the therapeutic range.
Authors:
Annelies C P Van Strater; Jan P A M Bogers
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-11-22
Journal Detail:
Title:  International clinical psychopharmacology     Volume:  -     ISSN:  1473-5857     ISO Abbreviation:  -     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-11-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8609061     Medline TA:  Int Clin Psychopharmacol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
aDepartment Duin & Bollenstreek bDepartments of Haagstreek, Midden-Holland, and Duin & Bollenstreek, Psychiatric Centre Rivierduinen, The Netherlands.
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