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Doxepin

Doxepin 10mg, 25mg, 50mg, 75mg

Doxepin is a tricyclic antidepressant primarily used to treat depression and anxiety disorders, as well as insomnia. It works by balancing certain chemicals in the brain, which can help improve mood and promote restful sleep. Additionally, it may also be prescribed to alleviate symptoms of chronic pain and anxiety. Doxepin is known for its sedative effects, making it particularly useful for individuals experiencing sleep disturbances related to their mental health conditions.

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Description

Doxepin is a tricyclic antidepressant that is primarily used for the treatment of depression and anxiety disorders. Additionally, it is effective for managing insomnia and certain allergic conditions. Doxepin works by influencing the balance of neurotransmitters in the brain, particularly serotonin and norepinephrine, thereby improving mood and relaxation.

Uses / Indications

  • Major depressive disorder
  • Generalized anxiety disorder
  • Insomnia (especially when associated with anxiety or depression)
  • Chronic pain management (as an adjunct therapy)
  • Pruritus associated with eczema or other skin conditions

Dosage and Administration

Adults:
Initial dosage for depression and anxiety is typically 75 mg daily, which may be adjusted based on response or tolerance. For insomnia, dosages may start as low as 3 mg to 6 mg at bedtime.

Elderly:
Start with a lower dose (e.g., 25 mg daily) due to increased sensitivity and risk of side effects.

Note: Dosage may vary based on individual medical conditions and doctor’s advice.

How It Works (Mechanism of Action)

Doxepin primarily works by inhibiting the reuptake of serotonin and norepinephrine, which increases their levels in the brain. This action helps to enhance mood and alleviate anxiety. Additionally, Doxepin has antihistamine properties, which can aid in preventing allergic reactions and promoting sleep.

Side Effects

Common side effects:

  • Drowsiness or sedation
  • Dry mouth
  • Constipation
  • Nausea

Rare/serious side effects:

  • Rapid heart rate or palpitations
  • Severe allergic reactions (rash, swelling, difficulty breathing)
  • Mania or hypomania in predisposed individuals

Seek medical attention if serious side effects occur.

Precautions / Warnings

  • Consult your doctor if you have a history of bipolar disorder, liver disease, or glaucoma
  • Use caution if combining with alcohol or other sedatives
  • May impair your ability to drive or operate machinery; use caution

Drug Interactions

Doxepin may interact with:

  • Monoamine oxidase inhibitors (MAOIs) – can lead to serious complications
  • Other antidepressants (may increase side effects)
  • Alcohol (may enhance sedative effects)
  • Benzodiazepines or other medications that cause drowsiness

Always inform your healthcare provider about any other medications or supplements you’re taking.

Storage Instructions

  • Store at room temperature (20°C–25°C / 68°F–77°F)
  • Keep away from moisture, heat, and direct light
  • Keep out of reach of children

Missed Dose / Overdose

Missed a dose?
Take it as soon as you remember. If it’s nearly time for your next dose, skip the missed dose. Do not double up.

Overdose symptoms:

  • Severe drowsiness or confusion
  • Rapid or irregular heartbeat
  • Pupil dilation
  • Seizures (in severe cases)

Contact a poison control center or seek emergency medical help immediately.

Contraindications

  • Allergic to Doxepin or similar compounds
  • Use of MAOIs within the last 14 days

Brand Names / Alternatives

  • Silenor
  • Zonalon
  • Prudoxin
  • Generic name: Doxepin