Drug information of Doxepin

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Doxepin

فارسی

doxepin is used to treat depression or anxiety .Doxepin is a tricyclic antidepressant. Doxepin affects chemicals in the brain that may become unbalanced.
Doxepin is used to treat symptoms of depression and/or anxiety associated with alcoholism, psychiatric conditions, or manic-depressive conditions.

Mechanism of effect

The mechanism of action of Doxepin hydrochloride is not definitely known. It is not a central nervous system stimulant nor a monoamine oxidase inhibitor.
The current hypothesis is that the clinical effects are due, at least in part, to influences on the adrenergic activity at the synapses so that deactivation of norepinephrine by reuptake into the nerve terminals is prevented.

Pharmacodynamic

Doxepin, a tricyclic antidepressant of the dibenzoxepin type, is used to treat depression and anxiety and, topically, pruritus associated with eczema. Doxepin has substantial anticholinergic and sedative effects.

Pharmacokinetics

Well-absorbed from the GI tract. Peak plasma concentrations occur within 2 hours of oral administration.
Doxepin and desmethyldoxepin is 80% protein bound. Extensively metabolized in the liver .
Half life: 6 - 24.5 hours.

Drug indications

Depression , Anxiety , Insomnia , Urticaria

Dosage

Usual Adult Dose for Anxiety For Mild Anxiety:
Initial dose: 25 mg per day in 1 to 3 divided doses.
Maintenance dose: 25 to 50 mg per day in 1 to 3 divided doses.
For Moderate Anxiety:
Initial dose: 75 mg per day in 1 to 3 divided doses.
Maintenance dose: 75 to 150 mg per day in 1 to 3 divided doses.
For Severe Anxiety:
Initial dose: 150 mg per day in 1 to 3 divided doses.
Maintenance dose: 150 to 300 mg per day in 1 to 3 divided doses.
The maximum single dose should not exceed 150 mg.
Usual Adult Dose for Depression For Mild Depression:
Initial dose: 25 mg per day in 1 to 3 divided doses.
Maintenance dose: 25 to 50 mg per day in 1 to 3 divided doses.
For Moderate Depression:
Initial dose: 75 mg per day in 1 to 3 divided doses.
Maintenance dose: 75 to 150 mg per day in 1 to 3 divided doses.
For Severe Depression:
Initial dose: 150 mg per day in 1 to 3 divided doses.
Maintenance dose: 150 to 300 mg per day in 1 to 3 divided doses.
The maximum single dose should not exceed 150 mg.
Usual Adult Dose for Urticaria Studies: 10 mg orally three times daily.

Alerts

1-Patients with major depressive disorder (MDD), both adult and pediatric, may experience worsening of their depression and/or the emergence of suicidal ideation and behavior (suicidality) or unusual changes in behavior.
2-Doxepin Hydrochloride Oral Solution is not approved for use in treating bipolar depression.
3-The pupillary dilation that occurs following use of many antidepressant drugs including Doxepin Hydrochloride Oral Solution may trigger an angle closure attack in a patient with anatomically narrow angles who does not have a patent iridectomy.

Points of recommendation

1-Since drowsiness may occur with the use of this drug, patients should be warned of the possibility and cautioned against driving a car or operating dangerous machinery while taking the drug
2- Patients should also be cautioned that their response to alcohol may be potentiated.
3-Sedating drugs may cause confusion and over sedation in the elderly; elderly patients generally should be started on low doses of Doxepin and observed closely.
4-Antianxiety effect is apparent before the antidepressant effect. Optimal antidepressant effect may not be evident for 2 to 3 weeks.

Pregnancy level

HAVE NOT BEEN ESTABLISHED

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