Doxepin: uses and side effects of this antidepressant drug

Antidepressants are currently widely used worldwide, especially to treat depression, but also for other conditions such as insomnia or anxiety. Here we will meet doxepin, a tricyclic antidepressant.

• Related article: "Types of antidepressants: characteristics and effects"

Doxepin: a tricyclic antidepressant

There are different types of antidepressants: MAOIs, tricyclics, serotonin inhibitors, norepinephrine inhibitors, dual, etc. Doxepin is a tricyclic antidepressant.

Tricyclic and tetracyclic antidepressants are among the first antidepressants to be developed. They are effective though they have now been replaced by other antidepressants with fewer side effects. In any case, they continue to be the most effective for certain disorders such as melancholic depression.

Going back to doxepin, its trade name is Silenor. This medicine is used to treat insomnia, that is, the difficulty in falling asleep or staying asleep, as well as depression and anxiety, mainly.

Mechanism of action

The mechanism of action of doxepin consists of block the reuptake of neurotransmitters by the neuronal membrane.

Its operation is based on slowing down brain activity so that sleep can take place, through the modification of the amounts of certain natural substances in the brain necessary for balance mental.

Therapeutic indications

The indications for doxepin are mainly psychoneurotic disorders where anxiety and/or depression are predominant symptoms: anxiety neurosis with or without somatic symptoms, reactive depression, mixed anxious depression.

It is also indicated for psychotic depressions including involutional melancholia and the depressive phase of manic-depressive psychosis. In addition, doxepin is also indicated to treat insomnia.

1. Insomnia

If used for insomnia, doxepin is taken as a tablet to take by mouth. Regarding the dosage, it is usually taken once a day, 30 minutes before going to sleep. It should not be taken within 3 hours after a meal.

After your take, the person often feels very sleepy, and stays asleep for a while after taking the medicine. It is recommended not to take doxepin if the person will not go to bed immediately and if they do not intend to stay asleep for 7 to 8 hours.

When starting treatment, the person will feel better during the first days. If in a week or 10 days it does not improve, or even worsens, it is advisable to call the doctor.

2. Anxiety and depression

In this case, doxepin is taken as a capsule or concentrate (liquid) to take by mouth. It can be taken with or without food three times a day. It is recommended to take it at approximately the same time every day.

• You may be interested in: "Types of depression: its symptoms, causes and characteristics"

3. Others

Doxepin also sometimes used to treat chronic hives without a known cause. In addition, the drug can be prescribed for other uses, although the most frequent are those mentioned: insomnia, anxiety and depression.

contraindications

Contraindications (when it should not be used) of doxepin are: when there is hypersensitivity to the drug or in the elderly with acute angle glaucoma or with a tendency to urinary retention.

Side effects

As for side effects, doxepin can cause nausea and dizziness, as well as a few others:

• vomiting
• Tiredness or weakness.
• Increase in the size of the pupil.
• Dry mouth.
• thrush in the mouth.
• Skin more sensitive than usual to sunlight.
• Blush.
• Changes in appetite or weight.
• Change in the taste of things.
• Indigestion.

On the other hand, it is recommended to call the doctor if any unusual problem occurs while taking doxepin, or if one or some of the mentioned side effects is severe or does not go away.

Suicidal tendencies with doxepin

It is important to note that during clinical studies of doxepin, a small number of children, adolescents and young adults (up to 24 years of age) who took antidepressants such as doxepin had tendencies suicidal. These were translated into thoughts such as harming or committing suicide, planning to do so or trying to do so.

Children, adolescents, and young adults who take antidepressants to treat depression or other mental disorders are known to are more likely to have suicidal thoughts than those not taking antidepressants to treat such conditions. However, experts do not know exactly to what degree this risk ranges and to what extent such a phenomenon should be considered if a young child or adolescent must take an antidepressant.

It should be noted that children under 18 years of age should not regularly take doxepin, although in some cases, the doctor may decide that doxepin is the best option.

Bibliographic references:

• Doxepin (Insomnia. NIH MedlinePlus Health [Internet]. 2017; Available from: https://medlineplus.gov/spanish/druginfo/meds/a617017-es.html. Spanish English.
• Doxepin (Depression, anxiety. NIH MedlinePlus Health [Internet]. 2017; Available from: https://medlineplus.gov/spanish/druginfo/meds/a682390-es.html. Spanish English.