Antidepressants increased the risk of suicidal thinking and behavior in short-term studies in children and adolescents with depression and other psychiatric disorders. Anyone considering the use of any antidepressant in a child or adolescent must balance this risk with the clinical need. Patients who are started on therapy should be closely observed for clinical worsening, suicidal thinking or behavior, and unusual changes in behavior.
GENERIC AVAILABLE: Yes
PREPARATIONS: Capsules: 10, 25, 50, 75, 100, 150 mg; Liquid: 10 mg/ml
STORAGE: Doxepin should be stored below 30 C (86 F) in a tight, light resistant container.
DOSING: The usual dose of doxepin for depression or anxiety is 25 to 300 mg daily administered at bedtime or in two or three divided doses. Doses greater than 300 mg daily are not more effective. Optimal improvement in depressive symptoms is seen after 2-3 weeks; anti-anxiety effects occur much sooner. Insomnia is treated with 3 to 6 mg daily taken 30 minutes before sleeping. Avoid taking doxepin with high fat meals because high fat meals increase the absorption of doxepin.
DRUG INTERACTIONS: Tricyclic antidepressants , including doxepin, should not be taken with any of the monoamine oxidase inhibitor (MAOI) class of antidepressants (for example, isocarboxazid [Marplan], phenelzine [Nardil], tranylcypromine [Parnate], selegiline [Eldepryl], and procarbazine [Matulane]) or other drugs that inhibit monoamine oxidase such as linezolid [Zyvox] and intravenous methylene blue. Such combinations may lead to confusion, high blood pressure, tremor, hyperactivity, coma, and death. Doxepin should not be administered for at least 14 days after stopping.
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