Antidepressant Medications Anti-depressant Drugs Antidepressant: doxepin, Sinequan, Adapin

Antidepressant: doxepin, Sinequan, Adapin

Generic Name: doxepin
Brand Name(s): Sinequan, Adapin
Common Use: Antidepressant

Doxepin is a psychotropic agent with antidepressant and anxiolytic properties. It also has sedative and anticholinergic effects, and, in the higher dosage range, it produces peripheral adrenergic blocking effects.

The drug treatment of:
1. Psychoneurotic patients with anxiety and/or depressive reactions. Anxiety neurosis associated with somatic disorders; alcoholic patients with anxiety and/or depression.

2. Psychotic depression, including manic-depressive illness (depressed type) and involutional melancholia.

Doxepin is contraindicated in individuals who have shown hypersensitivity to the drug or to other dibenzoxepin compounds.

Since drowsiness may occur with the use of this drug, patients should be advised against driving or engaging in activities requiring mental alertness and physical coordination until their response to the drug has been well established.

Patients should be warned that the effects of other drugs acting on the central nervous system, such as alcohol, barbiturates and other CNS depressants, may be potentiated by doxepin.

Adverse Side Effects

Although some of the adverse reactions included in the following list have not been reported with doxepin pharmacological similarities among the tricyclic antidepressants require that each of the reactions be considered when prescribing doxepin.

Drowsiness, fatigue, excitement, agitation, restlessness, insomnia, nightmares, hypomania, anxiety, confusion, disorientation, disturbed concentration, delusions, hallucinations, activation of latent psychosis.

Seizures, alteration in EEG patterns, dizziness, tremors, extrapyramidal symptoms, numbness, tingling, paresthesias of the extremities, peripheral neuropathy, tinnitus, syndrome of inappropriate ADH (antidiuretic hormone) secretion.

Hypotension, hypertension, tachycardia, palpitations. A quinidine-like effect and other reversible ECG changes such as flattening or inversion of T-waves, bundle branch block, depressed S-T segments, prolonged conduction time and asystole, arrhythmias, heart block, fibrillation, myocardial infarction, stroke and unexpected death in patients with cardiovascular disorders have been reported with other tricyclic antidepressants.

Dry mouth, blurred vision, disturbances of accommodation, mydriasis, constipation, nasal stuffiness, delayed micturition, sublingual adenitis, paralytic ileus, urinary retention, dilation of the urinary tract, precipitation of latent and aggravation of existing glaucoma, vertigo.

Increased or decreased libido, impotence, menstrual irregularity, testicular swelling, breast enlargement and galactorrhea in the female, gynecomastia in the male, elevation and lowering of blood sugar levels.

Pruritus, skin rash, photosensitization, edema, drug fever, leukopenia, urticaria, petechiae, obstructive jaundice and bone marrow depression, including agranulocytosis, eosinophilia, purpura and thrombocytopenia.

Nausea, epigastric distress, vomiting, flatulence, abdominal pain, diarrhea, peculiar taste, stomatitis.

Weakness, headache, weight gain or loss, excessive appetite, anorexia, increased perspiration, urinary frequency, lacrimation, alopecia, parotid swelling, black tongue, hepatitis.

Abrupt cessation of treatment with tricyclic antidepressants after prolonged administration may produce nausea, headache and malaise. These symptoms are not indicative of addiction.

Overdose

Excessive drowsiness leading to minor alterations of consciousness and even unresponsiveness could be an early indication of excessive dosage. However, overdosage with doxepin is more likely to be manifested by increased psychomotor agitation and convulsions leading to apnea and coma.In general, treatment of overdosage should be symptomatic and supportive.

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