Doxepin is prescribed for the management of mental and mood disorders, specifically addressing conditions such as depression and anxiety. Its therapeutic effects encompass mood enhancement, the alleviation of anxiety and tension, promotion of improved sleep quality, and augmentation of energy levels. Classified within the pharmacological category of tricyclic antidepressants, this medication exerts its mechanism of action by modulating the equilibrium of specific naturally occurring neurochemicals, known as neurotransmitters, within the central nervous system.
Uses and Dosage
Doxepin is available in capsule form or as a concentrated liquid for oral administration. Typically, it is recommended to be taken once to three times a day, with or without food, ideally at consistent intervals daily.
Strictly follow the prescribed dosage regimen for doxepin, avoiding both overuse and underuse, as well as exceeding the recommended frequency as outlined by your physician.
For the doxepin concentrate in oral liquid form, it includes a specially calibrated dropper for accurate dosing. Consult your pharmacist for proper dropper utilization guidance. Prior to consumption, dilute the concentrate in 4 ounces (120 mL) of water, whole or skim milk, or any of the recommended fruit juices, including orange, grapefruit, tomato, prune, or pineapple juice. Refrain from mixing it with carbonated beverages, such as soft drinks.
The full therapeutic effect of doxepin may take several weeks or more to become noticeable. Even if you begin to feel well, maintain your doxepin regimen as directed. Discontinuing doxepin without consulting your healthcare provider is not advised. Typically, your doctor will recommend a gradual dose reduction when it is deemed appropriate.
Some side effects may occur that usually do not need medical attention:
- weakness or tiredness
- increase in pupil size
- dry mouth
- mouth sores
- skin more sensitive to sunlight than usual
- changes in appetite or weight
- changes in the way things taste
- difficulty urinating
- excessive thirst and urination
- ringing in your ears
- changes in sex drive
- swollen testicles
- increased breast size
- milky discharge from nipples in females
- excessive sweating
- hair loss
Inform your healthcare provider immediately if you experience any serious side effects:
- yellowing of the skin or eyes
- fast heartbeat
- unusual bleeding or bruising
- skin rash, itching, or swelling
Before initiating doxepin treatment, inform your healthcare provider or pharmacist of any known allergies, including allergies to doxepin itself, other tricyclic antidepressants like nortriptyline, or any other allergens. This product may contain inert components that have the potential to trigger allergic reactions or other adverse effects.
Provide a comprehensive medical history to your doctor or pharmacist before commencing this medication, with specific attention to conditions such as bleeding disorders, respiratory issues, liver disorders, recent heart attacks, urinary difficulties due to an enlarged prostate, hyperthyroidism (overactive thyroid), personal or familial history of angle-closure glaucoma, personal or familial history of mental health disorders such as bipolar disorder or psychosis, family history of suicide, seizures, or any medical conditions that may elevate the risk of seizures.
Doxepin may lead to a condition known as QT prolongation, which can infrequently result in serious instances of rapid or irregular heartbeat, along with associated symptoms like severe dizziness and fainting. Prompt medical attention is essential in such cases. The risk of QT prolongation may be heightened if you have certain medical conditions or are taking medications that can induce QT prolongation. Inform your doctor or pharmacist of all the medications you are currently taking and whether you have specific heart issues, including heart failure, bradycardia (slow heartbeat), or a history of QT prolongation on an electrocardiogram (EKG), as well as a family history of such cardiac problems or sudden cardiac death.
Low levels of potassium or magnesium in the blood may amplify the risk of QT prolongation. This risk may escalate if you are using particular medications like diuretics (“water pills”) or experiencing conditions such as profuse sweating, diarrhea, or vomiting. Discuss the safe use of doxepin with your doctor in such circumstances.
Doxepin may induce dizziness, drowsiness, or blurred vision. The consumption of alcohol or marijuana can exacerbate these effects. Avoid engaging in activities requiring alertness or clear vision, such as driving or operating machinery, until you can do so safely.
This medication may heighten your sensitivity to sunlight. Exercise caution when exposed to the sun, restrict tanning booth and sunlamp use, and employ sunscreen and protective clothing while outdoors. Notify your doctor immediately if you experience sunburn or skin blistering/redness.
If you have diabetes, be aware that doxepin may make it more challenging to manage your blood sugar levels. Regularly monitor your blood sugar levels and inform your doctor of the results. Adjustments to your diabetes medication, exercise regimen, or diet may be necessary.
Elderly individuals may exhibit increased susceptibility to the side effects of doxepin, particularly dry mouth, dizziness, drowsiness, confusion, difficulty urinating, and QT prolongation.
During pregnancy, this medication should only be used when deemed absolutely necessary. Babies born to mothers who have taken this medication during the last three months of pregnancy may occasionally manifest withdrawal symptoms, such as feeding and breathing difficulties, seizures, muscle stiffness, or persistent crying. If you observe any of these symptoms in your newborn, promptly consult a healthcare professional.
Given the seriousness of untreated mental and mood disorders such as depression and anxiety, discontinuation of this medication should only occur under the direct guidance of your doctor. If you are contemplating pregnancy, become pregnant, or suspect pregnancy, it is essential to discuss promptly with your healthcare provider the potential advantages and risks associated with using this medication during pregnancy.
This medication is excreted into breast milk and may have adverse effects on a nursing infant. Breastfeeding while using this drug is discouraged. Consult your doctor before proceeding with breastfeeding.
Form and Strength
Sinequan is available in the following forms and strengths:
How long will it take for Sinequan to work?
It can take 2 to 3 weeks before you notice the full effects of Sinequan when treating depression, but can take longer. You might notice that it works to treat your anxiety symptoms sooner.
Will Sinequan make me sleepy?
Sleepiness is the most common side effect of Sinequan, but it tends to get better the longer you take it.