What is Doxepin?
Doxepin belongs to a group of tricyclic antidepressants. It has various clinical effects, such as antidepressant, anti-panic (anxiolytic), centrally acting analgesic, mild anti-ulcer, anti-itching. It has a sedative and an alpha-adrenoceptor blocking action, decreases intraventricular conduction in high doses. The drug may cause severe arrhythmias if taken in large dosages, even with heart failure in extreme cases.
Fast anxiolytic and retarded antidepressant action are realized due to the accumulation of serotonin and noradrenaline in the central nervous system and synapses by disrupting their reuptake inhibition as a result of reverse neuronal uptake. Long time use of Doxepin normalizes adrenergic and serotonergic transmission, which are violated in depressive states. It improves mood, eliminates apathy, reduces anxiety, panic, and depressive symptoms. The drug is effective to treat both eating disorders accompanied by depression and without it. It also reduces autonomic manifestations of neurotic disorders.
The central analgesic action is also associated with the accumulation of serotonin and influence on the endogenous opioid system.
Doxepin is quickly and completely absorbed. It bounds to plasma proteins almost completely (90%). It is excreted by kidneys in an altered state in a form of metabolites.
What Doxepin is used for?
Doxepin (Sinequan) is used to treat:
- Depression (as a manifestation of manic-depressive disorder as well as cognitive impairment), in case of anxiety neuroses, neurosis-like states, psychosis, chronic alcohol addiction, organic CNS lesions;
- Panic disorder;
- Neurotic reactions with persistent pronounced vegetative reactions and sleep disorders;
- Premedication prior to minimally invasive procedures that do not require general anesthesia (for example, before the endoscopic examination);
- In the treatment of peptic ulcer disease, premenstrual syndrome and various chronic pain syndromes, especially with neuropathy; prevention of migraine, skin itching.
Take Doxepin pill immediately after your meals (the drug irritates the stomach lining), washing down with a glass of water up to 2 times a day. The initial daily dosage, in case of moderate clinical manifestations, is Doxepin 75 mg. The dosage may then be increased to 150mg or even 300 mg a day in case of expressed symptoms of depression.
Reduce Doxepin daily dosage to 25-50 mg in case of minimal depressive and anxiety disorders. Treatment with Doxepin usually lasts 2 to 3 weeks with a gradual dosage reduction to a full cancellation.
Around 25-50mg of Doxepin is administered intramuscularly to prepare for endoscopic and other minimally invasive medical examinations, depending on the patient's weight and volume of examination. The drug is taken half an hour before a clinical research.
Doxepin side effects
Possible side effects of Doxepin are mainly associated with anticholinergic action: blurred vision, increased intraocular pressure with a predisposition, violation of the bipolar view, increased heart rate, arrhythmia, different degrees of intraventricular blocks, the decrease in peripheral pressure, dry mouth, stomatitis, dyspepsia, constipation, urinary retention, dry skin.
Disorders of consciousness in a form of confusion, mnemonic and cognitive impairment were also reported. The drug intake can worsen depressive symptoms, psychotic disorders, lead to productive hallucinatory symptoms, delirious states in definite cases. Paresthesia, myasthenia gravis, frequent epileptic episodes are also possible.
Hematopoiesis disorders: eosinophilia, cytopenia, hemorrhagic vasculitis.
Endocrine system disorders: testicular swelling, gynecomastia; an increase of breast size, galactorrhea; decreased or increased libido, reduced potency, electrolyte disorders, carbohydrate metabolism, liver and kidney function disorders.
Allergic reactions: urticaria, angioneurotic edema.
Avoid taking Doxepin in case of:
- you take MAO inhibitors 2 weeks before the start of treatment;
- personal intolerance to any of the drug's components;
- angle-closure glaucoma;
- cardiac arrhythmias and conduction;
- an acute phase of myocardial infarction.
Children under 12 years old should also avoid taking Doxepin
Take Doxepin with caution in case of:
- chronic exogenous intoxication (Ethanol);
- bronchial asthma;
- manic-depressive psychosis;
- pregnancy (especially I trimester);
- breastfeeding (because the drug penetrates into breast milk and may cause depression of nervous system of a child);
- severe cardiovascular system disorder;
- cerebrovascular disorder;
- gastrointestinal tract motor function disorder,
- increased intraocular pressure;
- liver and / or kidney failure;
- prostatic hyperplasia;
Advanced age people should also use Doxepin with caution
Can I take Doxepin during pregnancy and breastfeeding?
Avoid taking Doxepin during pregnancy, especially in the first trimester, and during breastfeeding. The drug penetrates into breast milk and causes central nervous system depression of a newborn.
Animal experiments have revealed teratogenic effects. There are no clinical data about using the drug for pregnant women. Pregnant women should only take Doxepin if the expected benefit for mother far exceeds the potential risk to a fetus.
Take Doxepin with caution with other drugs depressing the central nervous system, anticholinergics, anticoagulants, thyroid hormones, hematologic medications.
Increased dosages of Doxepin are required if the drug is used together with barbiturates, oral contraceptives, nicotine.
Fluoxetine and fluvoxamine increase Doxepin concentration in blood.
Simultaneous intake of Doxepin with antiarrhythmic drugs (quinidine derivatives, for example), can enhance intraventricular conduction disorder. Doxepin is incompatible with MAO inhibitors.
Concomitant use of the drug with nasal and intraocular alpha-agonists enhances their vasoconstrictor effect.
You may experience the following side effects in case of overdose with Doxepin: lethargy, coma, ataxia, hallucinations, agitation, increased reflexes, muscle stiffness, seizures, hemodynamic instability, heart rate disorders, cardiogenic, arrhythmogenic shock, respiratory depression, indigestion, decreased amount of urine up to anuria.
If you think you took too much of Doxepin and start to feel any of unpleasant side effects listed above, seek medical attention immediately.
What is the safe place to buy Doxepin (Sinequan) online?
You can buy generic Doxepin online without prescription in numerous pharmacy websites. Be careful to choose an established drugstore in order to avoid buying fake drugs. You can also purchase Sinequan brand medication in your local drugs store. However, you need to have a prescription to buy Sinequan.
Doxepin (Sinequan) price may vary on every drugstore website.