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  Doxepin

 


Doxepin

Doxepin review




It seems like you’re really itching to get rid of depression. Let’s understand this drug further and how it gets rids of depression and even itchiness.

As a psychotropic agent, it is known to have tricyclic antidepressant and anxiolytic benefits. As doxepin hydrochloride, it is the active ingredient for the treatment of dermatological itch.

Inhibiting reuptake of serotonin and noradrenaline from the synaptic cleft, its reuptake-inhibitions is very weak. Noted antagonistic effects on a various postsynaptic receptors include extremely strong : histaminic H1, H2, ; strong : serotonergic 5-HT2, adrenergic alpha1, muscarinic; moderate : serotonergic 5-HT1; weak : dopaminic D2, adrenergic alpha2

It’s approved use by the Food and Drug Administration is only for the treatment of depression. However, it is also used for the treatment of Anxiety disorder, long-term-treatment is possible, extreme itching, due to allergies or other etiologies, long-term treatment for insomnia, to alleviate the symptoms of alcohol and drug withdrawal (co treatment with benzodiazepines or barbiturates is required for its effective use), gastrointestinal ulceration and other GI-problems (this is because of the strong H2-receptor-Inhibitors), chronic pain, particular tension headaches, either associated with depression or not, and the topical treatment of itchy skin diseases.

Complete and differentiated blood count should be undertaken and if any yields pathologic, blood count is required to be monitored closely under therapy with doxepin. If normal, blood counts should be taken in regular intervals during therapy. It is also advised for liver function studies to be performed periodically.

It is also absolutely not recommended for children under 12 years of age due to lack of experience for this age group.

It was also reported that some patients with cardiovascular disorders died after receiving high doses of Tricyclic antidepressant drugs.

Given the said facts, Doxepin should be used with extreme caution for patients with a history of cardiovascular diseases and circulatory liability and elderly patients. Treatment for such cases should be given in low doses and then progressively increased if required. Because tricyclic agents are known to reduce seizure threshold, it should be used with caution on patients with a history or convulsive disorders as well. Required close supervision should be given to hyperthyroid patients.

For pregnant women and their lactation, the newborn may show a withdrawal syndrome with agitation, impaired cardio-respiratory functions, disturbed urination and defecation if used chronically during pregnancy. And since Doxepin is found in significant amounts in the milk of lactating women, it is necessary to interrupt lactation during treatment.

Suicidal Patients or those with previous suicidal attempts require close monitoring if they are under treatment with Doxepin.

Doxepin has acknowledged side effects such as fatigue, dizziness, drowsiness, lightheadedness, confusion, nightmares, agitation, increased anxiety, insomnia, seizures (infrequently), delirium, rarely induction of hypomania and schizophrenia (stop medication immediately), extra pyramidal side-effects (rarely), abuse in patients with polytoxikomania (rarely) for the Central Nervous System; frequently increased appetite, massive weight gain, rarely nausea, frequently impaired sexual function in men (impotence, ejaculation-difficulties), rarely hypertension, rarely polyneuropathy, in both sexes breast-enlargement and galactorrhea (rarely).

Doxepin has the following structural formula:

Chemical structure of doxepin


• Molecular formula of doxepin is C19H21NO
• Molecular weight is 279.376 g/mol
Doxepin available : 50mg tablets, 100mg tablets



Brand name(s): Adapin, Aponal, Curatin, Doxepina, Doxepine, Doxepinum, Novo-Doxepin, Quitaxon, Sinequan, Triadapin, Zonalon


Review published on: 27 February 2008

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