Doxepin is a tricyclic antidepressant in use since the 1960s, most commonly to treat anxiety and depression, though also to treat other disorders. It should not be used in patients under 12 years of age, nor by women who are pregnant or breastfeeding.

As a serotonin-norepinephrine reuptake inhibitor (SNRI) the medication is thought to work by increasing concentration of serotonin and norepinephrine, though it also has other effects. As is the case with all antidepressants this is all speculative; the exact mechanism by which it works is not clearly understood.

Patients usually buy doxepin under the brand names Sinequan, Adapin, Curatin, and Doxepin. It is additionally sold as Silenor, though only low doses for treatment of insomnia.

Taking Doxepin

Patients buy doxepin to treat several conditions, including:

• Depression
• Anxiety
• Nerve pain
• Itchiness
• Insomnia
• Other conditions

The dosage and duration of treatment with doxepin will vary according to what it's being taken for. In the case of depression and anxiety, which are often both present in the same person, treatment is typically:

• Start with 75 mg per day.
• Dosage can be gradually increased up to 300 mg per day.
• Doses up to 150 mg per day can be taken in a single dose before bed.
• Doses greater than 150 mg should be divided into two daily doses.
• The majority of patients find 75 to 150 mg per day to be optimal.

In the above cases, effects may be noticeable within days of starting treatment, particularly anti-anxiety effects. It will take two to three weeks for full anti-depression effects to be felt; if results are not powerful enough after two or three weeks, dosage should be increased. It is, however, very unusual for dosage to exceed 300 mg per day. Treatment typically lasts at least nine months.

Patients also buy doxepin to treat insomnia, nerve pain, itchiness, and other conditions. In these cases the medication is typically administered in doses of 25 to 50 mg per day, though there is some variation; dosage may be smaller or larger. In smaller doses, treatment may span several days to years.

Dosage Forms

It's possible to buy doxepin in several formulas, including tablets, oral concentrate, and topical solution. Tablets and oral concentrate are largely interchangeable dosage-wise. Topical solutions are in their own category, used to treat mild to moderate itchiness in conditions like eczema. As a topical solution the medication is typically sold as Prudoxin or Zonalon.

Treatment with tablets is highly variable. Treatment with topical solutions typically lasts no more than eight consecutive days.

Those who buy doxepin tablets or oral concentrate report that it helps alleviate:

• Depression
• Anxiety
• Fatigue
• Apprehension
• Worry
• Guilt
• Difficulty sleeping
• Tension

In any form, doxepin should not be used if an MAO inhibitor has been taken in the past 14 days. It also should not be taken if allergic to similar medications, including amitriptyline, amoxapine, clomipramine, desipramine, imipramine, nortriptyline, protriptyline, or trimipramine.

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