Doxepin is an active ingredient belonging to the group of tricyclic antidepressants. It is mainly used to treat depression, but it can also be used for anxiety and addiction therapy. Ingestion may cause side effects such as tiredness, dizziness, itching and weight gain. Learn more about the effects, side effects and dosage of Doxepin.
Doxepin belongs to the group of tricyclic antidepressants, which also include active substances such as amitriptyline or opipramol. The drug is not only used to treat depression but can also help with anxiety and sleep disorders. In addition, he comes in addiction therapy, especially in opiate-dependent persons used.
Doxepin has a dampening and mood-enhancing effect. While the muted effect usually sets in within an hour of ingestion, mood enhancement often does not appear until after two to three weeks. Therefore, especially patients with suicidal thoughts at the beginning of the intake must be closely monitored. With regard to the damping effect, it must be taken into account that this can be lessened if the antidepressant is taken for a longer period of time.
Effect of doxepin
Doxepin increases the concentration of serotonin and norepinephrine in the brain by inhibiting the reuptake of messengers into their stores. In addition, the drug blocks the histamine receptors and thereby reduces the effectiveness of the tissue hormone histamine. Similarly, doxepin reduces the effectiveness of the messenger acetylcholine. This can be expressed, inter alia, in a lower blood pressure and a slowed heartbeat.
Side effects of doxepin
For example, the following side effects may occur at the beginning of treatment with doxepin:
- dry mouth
- Drop in blood pressure
- increase in weight
Later, allergic skin reactions and itching, sexual dysfunction, urinary problems, thirst and anxiety are among the common side effects. Occasionally it may also lead to disorders of the conduction, circulatory problems, urinary behavior, abnormal tissue sensations such as tingling, tinnitus and increased dreaming.
Finally, the very rare side effects of Doxepin include breast enlargement (in both men and women), changes in blood sugar levels, hair loss, changes in the blood count, cardiac arrhythmias, and drug-dependent hepatitis.
Dose Doxepin correctly
The active ingredient doxepin is available in various dosage forms, including tablets, dragees, capsules, drops or injectable solutions. The exact dosage is determined individually by the attending physician. Please understand the following dosage information only as a general guide.
When Doxepin is used to treat depression, usually only a small dose is prescribed at the beginning of therapy. This is then gradually increased until the smallest effective dose is determined. Usually 50 milligrams are started, then the dose can be increased relatively quickly up to 150 milligrams. With a stationary stay in the hospital up to 300 milligrams are possible.
Older persons are at increased risk of side effects. You should therefore take the antidepressant as low as possible. This is also useful because they can lead to confusion by taking them.
Overdose is dangerous
If Doxepin is overdosed, seek medical attention immediately, as overdose may result in severe side effects. Depending on how high the dose was, it can lead to disorders of the cardiovascular system and the central nervous system. This can cause confusion and seizures, in severe cases, coma and respiratory arrest.
To avoid overdose, do not make up for a missed dose. Instead, continue the intake as usual at the next time.
Treatment with doxepin should never be stopped abruptly, especially if the drug is taken over a longer period of time and in high doses. Otherwise, side effects such as nausea, vomiting, restlessness and sleep disturbances can occur. Always discuss with your doctor the best way to stop taking the drug. As a rule of thumb, the dose should not be reduced more than half each week.
Taking other antidepressants or Parkinson's medicines at the same time may increase the effects and side effects of doxepin. In addition, the attenuating effect of neuroleptics, sedating antihistamines, antiepileptic drugs, painkillers, sleepers and tranquilizers and the active ingredient cimetidine can be enhanced. Alcohol may also increase or alter the doxepin effect.
Medicines that lower potassium levels, block hepatic degradation of doxepin, or prolong the QT interval should also not be taken concomitantly with the antidepressant. The same applies to medicines for hypertension (clonidine, reserpine). If Doxepin is used concomitantly with H1 antihistamines, neuroleptics, antimalarials, antibiotics, neuroleptics or antiarrhythmic drugs, this may increase existing cardiac arrhythmias.
Interactions with MAO inhibitors
So-called MAO inhibitors, which are also used to treat depression, should not be taken concomitantly with doxepin. In general, the treatment should be stopped at least two weeks before beginning treatment with doxepin. Otherwise it can lead to serious side effects such as seizures, loss of consciousness, high fever and consciousness clouding.
For depression that is difficult to treat, in some cases the additional administration of MAO inhibitors is possible. However, the patient must then be observed carefully by the attending physician. In addition, the dose of MAO inhibitors may be increased only slowly.
Doxepin should not be used if hypersensitivity to the active substance is present. In addition, the antidepressant must not be taken at:
- a paralysis caused by paralysis
- acute urinary retention
- a poisoning with sleeping pills and painkillers as well as alcohol and psychotropic drugs
- acute delirium
- an enlargement of the prostate with residual urine formation
- a narrow-angle glaucoma
Only after a careful benefit-risk assessment, you should take the drug in severe liver damage, prostate enlargement without residual urine, slow heart rate, heart disease such as QT syndrome, potassium deficiency, blood disorders or increased spasm readiness.
In general, the use of Doxepin requires regular medical supervision. The blood pressure, ECG, liver function and blood count must be checked. If abnormal values are detected, treatment should be continued only if the patient is monitored at short intervals.
pregnancy and breast feeding period
Since insufficient experience exists in the use of doxepin during pregnancy, the antidepressant should only be taken when absolutely necessary. Before, a careful risk-benefit assessment should be performed by the physician. Because taking in the neonatal withdrawal symptoms can occur. Eventually, the danger of a malformation increases.
Do not take Doxepin while breast-feeding, as the active substance may pass into breast milk. This may cause side effects in the baby. If treatment is absolutely necessary, it should be weaned first.
Children under the age of twelve are not allowed to take the antidepressant like breastfeeding mothers. Because there are no studies on the impact of long-term use on growth, maturation and cognitive development of children and adolescents. Doxepin is also generally not used in adolescents up to the age of 18, as the active substance probably has no therapeutic benefit for them.