Doxepin hydrochloride (
Sinequan®) is a prescription medication that is used to treat
depression (also known as major depression or clinical depression). It is also approved to treat
anxiety.
It was originally made by Pfizer. However, brand-name doxepin is no longer available. Generic doxepin is still available and is made by several manufacturers of generic medications.
Doxepin belongs to a class of medications called
tricyclic antidepressants. It is not entirely clear how it works, but it does affect several chemicals in the brain (including serotonin and norepinephrine). It is thought that perhaps doxepin allows these chemicals to stay in the brain longer, which can help with depression symptoms and anxiety
(see Anxiety Symptoms). The medication can also block histamine receptors, making it useful as an antihistamine.
When and How to Take Doxepin
Some considerations for when and how to take the medication include:
- Doxepin comes in capsule form. It can be taken several times a day or all at once before bedtime. If the medication makes you drowsy, ask your healthcare provider about taking it just before bedtime.
- For people with trouble swallowing capsules, a liquid form (doxepin solution) is also available.
- You can take it with or without food. If it upsets your stomach, try taking it with food.
- It should be taken at the same time(s) each day to maintain an even level of the medication in your blood.
- For the medicine to work properly, you have to take it as prescribed. It will not work if you stop taking it.
The dosage that your healthcare provider recommends will vary depending on a number of factors, including:
- Your age
- The medical condition being treated
- Other medical conditions you may have
- Other medications you may currently be taking.
As with any medication, do not adjust your dose unless your healthcare provider specifically instructs you to do so.
As with any medicine, there are possible side effects. However, not everyone who takes the
antidepressant will experience side effects. In fact, most people tolerate the medicine well. When side effects do occur, they are often minor and either require no treatment or can easily be treated by your healthcare provider. Serious side effects are less common.
Common side effects of doxepin include:
(Click Doxepin Side Effects to learn about specific side effects of the drug, including some of the more serious side effects that you should report to your healthcare provider.)
You can also read about other possible side effects by clicking on the following links:
Doxepin can potentially interact with a number of medications.
What Should I Tell My Healthcare Provider?
You should talk with your healthcare provider prior to taking this medication if you have:
Also, let your healthcare provider know if you:
Be sure to tell your healthcare provider about all other medicines you may be taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.
Alternatives to Doxepin for Depression
Depression, even in its most severe form, is highly treatable. As with many illnesses, getting
depression treatment early is more effective and reduces the chance of recurrence.
The most common forms of treatment for depression are medication (
antidepressants) and psychotherapy ("talk therapy"). In some cases of severe depression, healthcare providers may recommend electroconvulsive therapy (ECT). Some people may also try complementary or alternative treatments for depression
(see Natural Remedies for Depression).
For most people, doxepin is quite effective at treating depression. It is also generally well-tolerated. However, side effects can occur, or the medicine may not work as well as needed. In these cases, your healthcare provider may recommend an alternative to doxepin. Some example of substitute depression medications include:
- Other tricyclic antidepressants
- Selective serotonin reuptake inhibitors (SSRIs)
- Serotonin-norepinephrine reuptake inhibitors (SNRIs)
- Norepinephrine and dopamine reuptake inhibitors (NDRIs)
- Monoamine oxidase inhibitors (MAOIs).
People who take too much doxepin may have overdose symptoms that could include:
- Change in heart rhythm (arrhythmia)
- Very low blood pressure (hypotension)
- Seizures
- Drowsiness
- Coma
- Confusion
- Trouble concentrating
- Hallucinations
- Dilated (wide open) pupils
- Agitation
- Muscle tension
- Vomiting
- Low body temperature (hypothermia) or fever (hyperthermia)
- Loss of life.
Overdose with doxepin can be very dangerous. If you happen to overdose, seek medical attention immediately.
The medication should be stored at room temperature, away from moisture and heat. Doxepin capsules and oral solution should be kept in an airtight container.
Keep doxepin and all medications out of the reach of children.
What Should I Do If I Miss a Dose?
If you do not take your doxepin as scheduled, take your missed dose as soon as you remember. However, if you usually take your dose at night, you may not want to make up the missed dose, due to the risk of drowsiness if doxepin is taken during the day. Also, if it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not take a double dose of doxepin.
Brand-name doxepin is no longer available. Generic doxepin capsules are available in the following strengths:
- Doxepin 10 mg capsules
- Doxepin 25 mg capsules
- Doxepin 50 mg capsules
- Doxepin 75 mg capsules
- Doxepin 100 mg capsules
- Doxepin 150 mg capsules.
The liquid form is available in one strength -- Doxepin solution 10 mg per mL.
Although brand-name doxepin is no longer being manufactured, generic doxepin is still available.
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