Last Updated on June 3, 2023
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Doxepin belongs to the group of medicines called tricyclic antidepressants. It has a calming effect and reduces the mental and physical activity. Prolonged ingestion Doxepin brightens the mood. Therefore, the active ingredient among other depressive disorders, anxiety and restlessness and sleep disorders is used. Here you can read everything about Doxepin.
How Doxepin affects
The mode of action of Doxepin is complex and not fully understood.
The drug affects the metabolism of neurotransmitters in the brain. It prevents primarily, that the messengers norepinephrine (mood-enhancing) and serotonin (“happy hormone”) are inactivated. This increases their availability. In this way, the gravity and duration of a depressive phase can be positively influenced. The mood-effect comes only a few days to weeks after the start of treatment.
Doxepin also inhibits certain protein molecules in cells that are responsible for receiving signals from the outside. This leads to a calming effect, makes you sleepy and reduces the mental and physical activity. These effects occur immediately.
Pharmacokinetics and metabolism of Doxepin
Doxepin is administered by mouth and well absorbed from the gastrointestinal tract into the body. A portion of the drug is immediately converted to another, also active substance in the liver in desmethylDoxepin. Both ingredients are fat-soluble and therefore can quickly reach the brain. They are finally broken down by the liver and then excreted in the urine and stool.
When is Doxepin applied?
The fields of application (indications) of Doxepin are:
- depressive disorders
- slight withdrawal symptoms associated with alcohol, drug or drug addiction
- restlessness or insomnia associated with depressive disorders or mild withdrawal symptoms
How Doxepin is used
Doxepin tablets or capsules should be swallowed whole with a glass of water before or after a meal or in the evening before bedtime.
depressive disorders and anxiety , treatment with an intake in the evening is started, and the dose after three to four days and then gradually increased again after seven to eight days.
In order to avoid a relapse, treatment should be continued for four to six months after resolution of symptoms. Thereafter, to complete the therapy, the dosage of Doxepin slowly reduced. As a result, withdrawal symptoms such as restlessness, insomnia, sweating, nausea and vomiting can be avoided.
For the treatment of withdrawal symptoms associated with alcohol, drug or drug addiction Doxepin is often administered 3 times daily. To end the therapy again, the dose is gradually reduced.
In elderly patients, dosage should be adjusted by your doctor, since these patients often lower doses sufficient to achieve a treatment effect, and the risk of side effects is increased.
If a sleep-promoting effect is desired, the greater part of dose should be taken at night.
What are the side effects Doxepin?
The most common side effects are Doxepin dry mouth, dry nose, disturbance of the near-far adaptation of the eye, sweating, fatigue, dizziness, increase in hepatic enzyme activity and weight gain. These side effects occur at more than ten percent of the patients affected.
With one to ten percent of patients experience allergic skin reactions, itching, thirst, urination disorders, restlessness, confusion states, loss of libido and impotence.
Doxepin can decrease the responsiveness. Therefore, during the treatment the ability to drive and the ability to work be impaired by machine.
What should I watch for while taking Doxepin?
Doxepin should not be used at:
- hypersensitivity to Doxepin or similar active ingredient (other Dibenzoxepine)
- acute poisoning with alcohol, sleeping pills, pain killers or medicines against mental illness
- acute delirium
- untreated narrow angle glaucoma (glaucoma)
- acute urinary retention (inability to urinate)
- benign enlargement of the prostate (prostatic hyperplasia) with residual urine
- intestinal paralysis (paralytic ileus)
- children under 12 years.
Doxepin should not be used in adolescents below 18 years since he has no medical efficacy in this age group.
Pregnancy and lactation
Doxepin should not be used during pregnancy, because it faces is no sufficient experience. Since the active substance passes into breast milk and may have undesirable effects in the infant, should breastfeeding mothers stop breastfeeding before starting treatment.
With a simultaneous taking Doxepin and a variety of other drugs can lead to interactions. Therefore it is important to the prescribing doctor about all – to inform drugs that are ingested
Doxepin should not be taken with other CNS depressants, since they mutually reinforce their effects can be. These include drugs that are used for depression, mental disorders or epilepsy, sleeping pills and tranquilizers, morphine-like painkillers and certain drugs for allergies (H1 antihistamines). Alcohol also affects CNS-depressant and should therefore be avoided during treatment.
Under no circumstances may Doxepin (Monoaminooxidasehemmstoffe = MAOI) be taken with certain other antidepressants, since it can cause serious side effects otherwise.
droperidol (remedy for nausea and vomiting reoperations) must not be taken together with Doxepin, otherwise increase the risk of palpitations. The same applies to pimozide and sertindole, two drugs against psychoses.
A simultaneous administration of drugs for heart rhythm problems (Amiodarone and quinidine) and malaria (lumefantrine), certain antibiotics and antihistamines (allergy agents) may lead to an increase of cardiac arrhythmias.
Doxepin enhances the effects of sympathomimetic agents – agents that have a stimulating effect on a part of the nervous system, which is responsible for vital functions such as heartbeat, blood pressure and respiration. Examples of such agents are adrenaline, Etilefrin, dopamine and pseudoephedrine.
Doxepin can attenuate the antihypertensive effect of certain hypertension agents (Clonidine, reserpine, α-methyldopa and guanethidine). In a simultaneous intake of nitrates or other hypertension agents (such as beta-blockers) may however increase the hypotensive effect.
Concomitant treatment with cimetidine (agent against gastrointestinal disease) may increase the side effects of Doxepin.
How to obtain medicines containing the active ingredient Doxepin
preparations with Doxepin are available by prescription and is available only by prescription in pharmacies.
Since when Doxepin is known?
Doxepin came 1970 on the market. The active ingredient of the tricyclic antidepressant Imipramine derives from, its mood enhancing effect was discovered by the Swiss psychiatrist Roland Kuhn 1957th
What you should also know about Doxepin
Doxepin, the light sensitivity of the skin to significantly increase, so that it can already lead to sunburn-like skin reactions in short-term sun exposure. So get sunlight during treatment with Doxepin Avoid or pay attention to a good sunscreen.