- Related Diseases
- Images & Quizzes
- A Visual Guide to Migraine Headaches Slideshow
- Headache and Migraine Triggers Slideshow
- Take the Migraines Quiz
- What is doxepin, and how does it work (mechanism of action)?
- What brand names are available for doxepin?
- Is doxepin available as a generic drug?
- Do I need a prescription for doxepin?
- What are the side effects of doxepin?
- What is the dosage for doxepin?
- Which drugs or supplements interact with doxepin?
- Is doxepin safe to take if I'm pregnant or breastfeeding?
- What else should I know about doxepin?
What is doxepin, and how does it work (mechanism of action)?
Doxepin belongs to a class of drugs called tricyclic antidepressants (TCAs) that are used primarily to treat depression and anxiety. Other examples of TCAs include amitriptyline (Elavil), nortriptyline (Pamelor), desipramine (Norpramin), and several others. Depression is an all-pervasive sense of sadness and gloom. In some patients with depression, an imbalance in levels of neurotransmitters in the brain may be the cause of the depression. Neurotransmitters are chemicals that nerves use to communicate with each other. Neurotransmitters affected by doxepin include serotonin, norepinephrine, acetylcholine, and histamine. Doxepin may elevate mood by raising the levels of serotonin and norepinephrine. It also blocks the activity of acetylcholine and histamine. The FDA approved doxepin in March 1974.
What are the side effects of doxepin?
The most common side effect of doxepin is drowsiness. Drowsiness improves as therapy continues. Other side effects associated with doxepin include:
- blurred vision,
- urinary retention (difficulty urinating),
- dry mouth,
- weight gain or loss,
- low blood pressure when rising from a sitting position (orthostatic hypotension),
- rapid or irregular heart rates,
- seizures, and
Doxepin also can cause elevated pressure in the eyes of some patients withglaucoma. Doxepin may dilate pupils which may trigger an angle closure attack in a patient with angle closure glaucoma.
If antidepressants, including doxepin, are discontinued abruptly, symptoms may include:
Such symptoms of withdrawal may occur even when a few doses of antidepressant are missed. Therefore, it is recommended that the dose of antidepressant be reduced gradually when therapy is discontinued.
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.
Quick GuideMigraine or Headache? Migraine Symptoms, Triggers, Treatment
What is the dosage for doxepin?
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.
Which drugs or supplements interact with doxepin?
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.
Is doxepin safe to take if I'm pregnant or breastfeeding?
There are no adequate studies of doxepin use in pregnant women.
What else should I know about doxepin?
What preparations of doxepin are available?
Capsules: 10, 25, 50, 75, 100, 150 mg; Liquid: 10 mg/ml
How should I keep doxepin stored?
Doxepin should be stored below 30 C (86 F) in a tight, light resistant container.
Reference: FDA Prescribing Information
Quick GuideMigraine or Headache? Migraine Symptoms, Triggers, Treatment
Daily Health News
Migraines and Headaches Resources
Subscribe to MedicineNet's General Health Newsletter
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
- doxepin (Sinequan and Adapin are discontinued brand in the US; Silenor) Related Diseases
- doxepin (Sinequan and Adapin are discontinued brand in the US; Silenor) Images & Quizzes
- doxepin (Sinequan and Adapin are discontinued brand in the US; Silenor) Index
Top doxepin Related ArticlesComplete List
Alcohol Abuse and AlcoholismAlcoholism is a disease that includes alcohol craving and continued drinking despite repeated alcohol-related problems, such as losing a job or getting into trouble with the law. It can cause myriad health problems, including cirrhosis of the liver, birth defects, heart disease, stroke, psychological problems, and dementia. Counseling and a few medications can be effective for alcoholism treatment.
Alcohol Abuse SlidesRead about the health risks of chronic heavy or binge drinking. Anemia, cancer, gout, cardiovascular disease and many more disease can be caused from heavy or binge drinking.
Alcohol QuizTake the Alcohol (Alcoholism) Quiz to learn how your alcohol is processed by your body and your brain.
AnxietyAnxiety is a feeling of apprehension and fear characterized by symptoms such as trouble concentrating, headaches, sleep problems, and irritability. Anxiety disorders are serious medical illnesses that affect approximately 19 million American adults. Treatment for anxiety may incorporate medications and psychotherapy.
Bipolar Disorder QuizWho is at risk for developing bipolar disorder? Are you? Take this Bipolar Disorder Quiz to learn more about bipolar disorder, if you're at risk, and what you can do about it.
CancerCancer is a disease caused by an abnormal growth of cells, also called malignancy. It is a group of 100 different diseases, and is not contagious. Cancer can be treated through chemotherapy, a treatment of drugs that destroy cancer cells.
DepressionDepression is an illness that involves the body, mood, and thoughts and affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. The principal types of depression are major depression, dysthymia, and bipolar disease (also called manic-depressive disease).
Depression SlideshowWhat is depression? Get information on symptoms, signs, tests, and treatments for many types of depression including major depression, chronic depression, teen depression, and postpartum depression.
Depression QuizMany people do not recognize the symptoms and warning signs of depression and depressive disorders in children and adults. With proper diagnosis, treatments and medications are available. Take this quiz to learn more about recovery from depression.
Fibromyalgia FactsFibromyalgia is a chronic pain condition characterized by symptoms such as fatigue, sleep disturbances, and tender points. Stress reduction, exercise, and medication are the standard treatments for fibromyalgia.
Fibromyalgia SlideshowWhat is fibromyalgia? Fibromyalgia is a chronic condition that causes pain and stiffness of the tendons, muscles, and joints. Learn about fibromyalgia symptoms, treatment and tender points.
Anxiety SlideshowLearn about generalized anxiety disorder (GAD). See if your worries are normal or something more by learning about symptoms, diagnosis, and treatments of anxiety disorders.
Head and Neck CancerHead and neck cancer is cancer of the oral cavity, salivary glands, paranasal sinuses and nasal cavity, pharynx, larynx, or lymph nodes in the upper part of the neck. These cancers account for 3% to 5% of cancers in the U.S. Tobacco and alcohol use are important risk factors. Treatment may involve surgery, radiation therapy, and/or chemotherapy.
Irritable Bowel Syndrome (IBS)
Irritable bowel syndrome (IBS) is a GI (gastrointestinal) disorder with signs and symptoms of:
- Abdominal pain
- Increased gas (flatulence)
- Abdominal cramping
- Food intolerance
Two new tests are now available that may help diagnose irritable bowel syndrome with diarrhea and constipation (IBS-M) and irritable bowel syndrome with diarrhea (IBS-D). Treatment for IBS includes diet changes, medications, and other lifestyle changes to manage symptoms.
Migraine headaches are severe headaches that are sensitive to light, sounds, and smells. Some people who suffer from migraines also have severe head pain. People also have symptoms of nausea and vomiting. Common migraine triggers may include:
- Certain foods
- Changes in barometric pressure
- Other phenomenon
They are diagnosed by a doctor if the headache pattern fits established migraine headache criteria. Over-the-counter (OTC) and prescription medications are sometime used to treat acute migraines. To prevent or reduce the frequency and severity of them doctors recommend supplements and prescription medications, for example:
- Blood pressure drugs
- Anti-seizure drugs
Lifestyle modification helps in migraine management. Many people who suffer from migraines get relief from their condition by keeping a headache diary, identifying and avoiding triggers, and taking appropriate medication.
Overactive BladderOveractive bladder is a sudden involuntary contraction of the muscle wall of the bladder causing urinary urgency (an immediate unstoppable need to urinate). Overactive bladder is is a form of urinary incontinence. Treatment options may include Kegel exercises, biofeedback, vaginal weight training, pelvic floor electrical stimulation, behavioral therapy, and medications.
Urinary RetentionUrinary retention (inability to urinate) may be caused by nerve disease, spinal cord injury, prostate enlargement, infection, surgery, medication, bladder stone, constipation, cystocele, rectocele, or urethral stricture. Symptoms include discomfort and pain. Treatment depends upon the cause of urinary retention.