Pharm

Doxepin

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Doxepin, Sinequan, Silenor, Adapin

  • See Also
  1. Tricyclic Antidepressant
  • Indications
  1. Major Depression
  2. Anxiety Disorder
  • Adverse Effects
  1. See Tricyclic Antidepressant
  2. Significant Anticholinergic effects, including sedation
  • Safety
  1. Unknown safety in pregnancy
  2. Avoid in Lactation
  • Mechanism
  1. See Tricyclic Antidepressant
  2. Primarily affects Norepinephrine reuptake
  • Dosing (Adults and Age over 12 years)
  1. Mood Disorders (Major Depression, Anxiety Disorder)
    1. Start: 75 mg orally at bedtime
    2. Titrate to 50 to 150 mg/day as tolerated and to effect
    3. Max: 300 mg/day (divide higher doses, above 150 mg/day, twice daily)
  2. Insomnia
    1. Adult: 6 mg orally 30 min before bed
    2. Elderly (over age 65 years): 3 mg orally 30 min before bed
      1. May advance to 6 mg orally as needed
  3. Pruritus
    1. Start 10 to 25 mg orally at bedtime
    2. Titrate to 10 to 100 mg/day as tolerated and to effect
  • Resources
  1. Doxepin (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=137a953b-3c48-405f-86a6-ff778cb7f5f2
  • References
  1. (2023) Med Lett Drugs Ther 62(1592): 25-32
  2. Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 38-9
  3. Hamilton (2020) Tarascon Pocket Pharmacopoeia