Doxepin
definition
Doxepin is used as a tricyclic antidepressant for depression, but also for the treatment of addictive diseases, especially opiate addiction.
Mechanism of action
Doxepin is a Reuptake inhibitors. That is, it prevents messenger substances like Norepinephrine, Dopamine and Serotonin in the Nerve cell of Brain be included. So there are more Neurotransmitters available, which are insufficiently present in depression.
dosage
The dosage of Doxepin is very individual. The Starting dose is mostly very low and is then slowly increased to the level at which the patient is stable. Doxepin can also not just canceled become. It has to be discontinued gradually, as a dose reducing.
The doctor can choose the dose individually for each patient recommended standard dose in depressed or anxious patients is included 50mg doxepin in the evening. After a few days, the dosage can increase 75mg be increased and after about a week on 100-150mg Doxepin rise. Doxepin can be taken throughout the day or in the evening.
It should be noted that there is very tired power. This sedative effect is often reduced with prolonged use of Doxepin. The desired mood-enhancing effect only occurs after 2 to 3 weeks on. In outpatient therapy, the total dose of 150 mg and in the case of inpatient treatment the total dose of 300 mg of doxepin must not be exceeded.
Doxepin is in the form of Hard capsules and should be swallowed whole with some liquid before or after meals. How long Doxepin should be taken depends on the patient's condition and on the doctor. This defines when the time for slow weaning should begin. The average is one Duration of treatment about 4 to 6 weeks.
application areas
Doxepin, as mentioned above, is a tricyclic antidepressant and can be used for various diseases. These include: depressive illnesses, morbid ones Anxiety, sleep disorders, as well as states of anxiety and restlessness associated with one depression, mild withdrawal symptoms Alcohol, Medication or Drug addiction.
Contraindications
As with others Medicines, there are also contraindications for Doxepin, which excludes the use of Doxepin:
- Hypersensitivity against doxepin or related substances
- Delirium (Impaired consciousness with additional hallucinations or delusions)
- Angle-closure glaucoma
- acute urinary retention
- Prostatic hyperplasia (Enlargement of the prostate gland) with additional residual urine formation
- in intestinal paralysis
- during the Breastfeedingbecause the active ingredient can pass into breast milk
- Children under 12 years.
Careful application
In certain circumstances it can Doxepin be taken, however, is one constant control of the doctor required. Caution is advised when using: severe Liver damage, Blood formation disorders, prostatic hyperplasia without residual urine, increased tendency to cramp, Potassium deficiency, slowed down Heart rate (Bradycardia), at Diseases of the heart, especially the conduction system or the Vessels concern such as: in the QT syndrome.
Sufficient results are currently not available on how Doxepin affects pregnancy, so it is not recommended to take it. Withdrawal symptoms may occur in the child after taking tricyclic or other antidepressants.
Side effects
If you experience any of the following side effects during therapy with Doxepin, see a doctor as soon as possible:
- Cardiac arrhythmias
- Manic Mood, i.e. a pathological state of extremely euphoric mood
- sudden onset of delusions or other hallucinations
- Change in the blood count (agranulocytosis = (almost) complete deficiency of the Granulocytes)
- purulent angina or another flu-like infection with a high fever
- Schüttelforst
- Inflammation in the ear, nose and throat, anal or genital area
Other possible side effects that occur especially at the beginning of therapy are: daytime tiredness, dryness nose such as dry mouth, Sweat, dizziness, Circulatory disorders, Racing heartTremors, blurred vision, Constipation and weight gain. In this case, too, you should report it to your doctor.
Common side effects are restlessness, itching, allergic skin condition, and decreased libido. Circulatory breakdowns occur less often, Urinary retention, Fluid retention, abnormal sensations such as tingling, cold or heat sensations as well tinnitus on.
Interactions
If you are taking or have recently taken other medicines, this must be reported to your doctor, as the use of Doxepin can lead to interactions with other medicines.
Taking Doxepin can make other drugs more effective. These include other antidepressants, sleeping pills, analgesics (pain relievers), neuroleptics, certain anti-allergic drugs, and anti-epileptic drugs such as carbamazepine. MAOIs are also used to treat depression.
MAOIs must be discontinued 14 days before taking Doxepin. Otherwise, serious side effects such as unconsciousness, high fever, seizures, sharp fluctuations in blood pressure or delirium can occur. This combination of symptoms is also known as serotonin syndrome.
