Doxepin: What Is it and What Is it For?
Antidepressants are a group of psychotropic drugs used to treat depression and other disorders. One of the first compounds discovered was tricyclic antidepressants, although their use has declined. Doxepin is a drug belonging to this group, and is useful in the treatment of depression and insomnia.
Depression is a mood disorder that has a very varied symptomatology. However, one of the characteristics is the loss of interest in carrying out activities that the person once enjoyed doing. Many people describe the presence of feelings such as sadness and anger that interfere with daily activities.
This disorder affects people of all ages and can have a multifactorial origin. In the case of older adults, studies show that the most common cause is fear of death. The treatment of depression can be complex, requiring a mixture of drugs and psychological therapies.
What is doxepin?
As we said before, the drug in question is a compound that belongs to the group of tricyclic antidepressants. In this sense, doxepin alters the concentration of some neurotransmitters in the brain, making it useful in the treatment of several different psychiatric conditions.
The use of tricyclic and tetracyclic antidepressants has decreased over the years. This is because compounds have emerged that produce the same pharmacological effect with fewer side effects. However, they’re still useful in certain types of disorders, and when the patient doesn’t respond to conventional treatment.
Doxepin can be found in different pharmacological formats such as capsules, tablets, and liquid concentrate, depending on the condition to be treated. It’s also possible to find the compound in a cream form, in order to treat skin conditions such as atopic dermatitis.
What’s the drug for?
The drug in question is useful in the treatment of a depressive disorder, especially melancholic depression. In addition, it’s effective in treating other psychiatric disorders such as anxiety. These effects are achieved by decreasing brain activity by altering the concentration of neurotransmitters.
Doxepin is also useful in treating certain sleep disorders such as insomnia. Studies show that the drug helps to maintain and prolong sleep, although it doesn’t help too much to actually help someone to get to sleep. In addition, doxepin triggers very few residual effects the day after its ingestion.
The topical presentation of the compound is very useful in the treatment of antihistamine-resistant urticaria. An investigation carried out in Turkey showed favorable results in 44.4% of the patients studied and the side effects were well tolerated by them.
Doxepins’s mechanism of action
The exact mechanism of action of tricyclic antidepressants is unknown, however, we do know that doxepin increases the levels of norepinephrine and serotonin in the brain. It does this by blocking the reuptake of these neurotransmitters in the neuronal membrane, which improves depression and anxiety.
The drug also has an affinity for histamine H1 receptors, and so it has a highly variable sedative effect. The sedative effect decreases brain activity, which is why it’s used in the treatment of various sleep disorders such as insomnia.
Finally, it’s believed that the antipruritic activity of the compound is also due to the occupation of H1 receptors in the cutaneous region. However, this last effect needs more research to be proven.
How should it be administered?
The administration of doxepin can vary depending on the pathology to be treated. Generally speaking, the intake is carried out orally in the treatment of depression and anxiety. In these cases, capsules or liquid concentrate are used, which should be ingested between 2 and 3 times a day, with or without food.
The concentrate, or oral liquid, comes with a dropper included, in order to measure the doses, which should be diluted in 120 milliliters of water or some other recommended liquid. It’s important to consult with the specialist in any questions that arise, and to ingest only the dose recommended by him.
For the treatment of insomnia, tablets are usually used orally, which should be ingested once a day in a period of 30 minutes before sleeping. It’s recommended not to ingest the medicine within 3 hours after the last meal, and you should also take into account that it will cause drowsiness.
Possible side effects of doxepin
All commercialized drugs are capable of causing side effects in those who consume them and doxepin is no exception. These symptoms aren’t usually too severe and disappear within a few days of starting treatment. Among the most frequent symptoms associated with the consumption of doxepin, the following stand out:
- Nausea and vomiting
- Weakness, tiredness, or drowsiness
- Increase in pupil size or mydriasis
- Dry mouth
- The appearance of canker sores
- Blurred vision
- Redness on the skin
- The skin being more sensitive to sunlight
If these symptoms don’t disappear after a few days, or if they get worse, then a doctor should be consulted immediately. In addition, one should also be aware of the presence of symptoms of liver damage such as a yellow staining on the skin and scleras.
Warning and contraindications
One of the main contraindications for taking doxepin is an allergy to the active ingredient or to any of the excipients. The drug is also contraindicated in elderly patients with glaucoma because it can increase intraocular pressure.
There are certain conditions that can affect the action of the drug such as heart failure, prostatic hypertrophy, arrhythmias, and advanced age. In all these patients, a dose readjustment must be carried out to avoid the appearance of collateral effects.
The safety of its consumption during lactation or pregnancy hasn’t yet been fully established, and so it should be avoided in these periods. Finally, it has been shown that the intake of doxepin generates suicidal tendencies in some adolescents and young adults, and so it should be used with great care in these patients.
An effective treatment for insomnia and depression
Doxepin is a tricyclic antidepressant used to treat psychiatric conditions such as depression and anxiety. In addition, the compound is also useful in reducing the symptoms of other conditions such as insomnia and chronic urticaria.
In general terms, this is a very safe drug, however, it must be consumed under strict medical prescription. It’s always important to consult a specialist when any questions arise regarding the dosage to use, and the appearance of any adverse symptoms.
- Llanes THM, López SY, Vázquez AJL, et al. Factores psicosociales que inciden en la depresión del adulto mayor. Revista de Ciencias Médicas de la Habana. 2015;21(1):65-74.
- Yeung WF, Chung KF, Yung KP, Ng TH. Doxepin for insomnia: a systematic review of randomized placebo-controlled trials. Sleep Med Rev. 2015 Feb;19:75-83.
- Özkaya E, Babuna Kobaner G, Yılmaz Z, Kutlay A. Doxepin in difficult-to-treat chronic urticaria: A retrospective, cross-sectional study from Turkey. Dermatol Ther. 2019 Jul;32(4):e12993.
- Spurling B, Clark L, Fusick AJ, Whiting WL. Doxepin: Misuse and Abuse. J Clin Psychopharmacol. 2018 Jun;38(3):279-280.
- Weber J, Siddiqui MA, Wagstaff AJ, McCormack PL. Low-dose doxepin: in the treatment of insomnia. CNS Drugs. 2010 Aug;24(8):713-20.
- Pinder RM, Brogden RN, Speight TM, Avery GS. Doxepin up-to-date: a review of its pharmacological properties and therapeutic efficacy with particular reference to depression. Drugs. 1977 Mar;13(3):161-218.