Doxepine is an instruction for use, reviews, analogs and formulations (capsules or tablets of 10 mg and 25 mg) of the drug for the treatment of depression, anxiety and phobia in adults, children and pregnancy. Composition

In this article, you can read the instructions for using the drug Doxepin. Presented are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors of specialists on the use of Doxepin in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Doxepin in the presence of existing structural analogues. Use to treat depression, anxiety and phobia in adults, children, as well as during pregnancy and lactation.Composition of the preparation.

Doxepin - an antidepressant of a tricyclic structure, a derivative of dibenzoxepine. The mechanism of action, apparently, is associated with the effect on adrenergic transmission in the central nervous system (CNS), in particular, with the blockade of neuronal seizure of noradrenaline. It also has anxiolytic, sedative activity, has m-cholinoblock effect. Does not have a stimulating effect on the central nervous system. Does not inhibit monoamine oxidase (MAO). Initially, the anxiolytic effect of doxepin (the active substance of the drug Doxepin) manifests itself, the optimal antidepressant effect develops after 2-3 weeks of treatment.

Composition

Doxepin + auxiliary substances.

Pharmacokinetics

Quickly and completely absorbed in the gastrointestinal tract (GIT). The maximum concentration of Doxepin in the blood is recorded after 1-3 hours. It penetrates the blood-brain barrier (GEB) and the placental barrier, into the milk of the nursing mother. Demethylated in the liver to demethylidosepin. It is excreted in the urine in the form of metabolites.

Indications

• depression and / or anxiety with neuroses, alcoholism, organic diseases of the central nervous system,psychoses (including involuntary depression and manic-depressive psychosis);
• bipolar affective disorder;
• depressive episodes;
• recurrent depressive disorders;
• phobic anxiety disorders (including agoraphobia - fear of crowded places, fear of open spaces, social phobia);
• sleep disorders of neurotic genesis;
• mixed anxiety and depressive disorders.

Forms of release

Capsules 10 mg and 25 mg (sometimes mistakenly called tablets).

Instructions for use and dosing regimen

The drug is dosed individually. With a moderate degree of depression and / or anxiety, the initial dose is 75 mg per day. In the future individually select an effective dose, which is usually 75-150 mg per day. Increase the dose gradually. With a significant depression and / or anxiety, the effective dose can reach 300 mg per day. In patients with minimal disturbances, smaller doses of 25-50 mg per day may be effective.

Doxepin is taken orally 1-2 times a day (with a single dose during the day, the dose of doxepin should not exceed 150 mg).In sleep disorders, most of the daily dose is taken in the evening.

The dose for children over 12 years is 0.5 mg per 1 kg of body weight per day.

Side effect

• dry mouth;
• nausea, vomiting;
• anorexia (a neuropsychic disorder manifested by an obsessive desire to lose weight, fear of obesity);
• violation of taste;
• diarrhea, constipation;
• aphthous stomatitis (presence on the mucous membrane of the oral cavity of aft - painful ulcerative defects);
• jaundice;
• dizziness;
• noise in ears;
• headache;
• visual impairment;
• drowsiness;
• disorientation;
• hallucinations;
• paresthesia (a sensitivity disorder characterized by sensations of numbness, tingling sensation, crawling crawling);
• ataxia (partial or complete loss of coordination of voluntary muscle movements);
• extrapyramidal disorders (changes in motor activity as a result of muscle tone disorders);
• convulsions;
• tremor (fast, rhythmic movements of limbs or trunk);
• arterial hypotension, hypertension (lowering, increasing blood pressure);
• tachycardia (increased number of heartbeats);
• leukopenia, agranulocytosis, thrombocytopenia, eosinophilia;
• increased or decreased libido (sexual desire);
• in men - swelling of the testicles, gynecomastia (enlargement of the breast with hypertrophy of glands and adipose tissue);
• in women - breast enlargement, galactorrhea (discharge from the nipples of the mammary glands of colostrum, milk or milk-like fluid);
• increase or decrease in blood sugar;
• decreased body weight;
• skin rash, itching;
• photosensitization (the phenomenon of increasing the sensitivity of the body, more often the skin and mucous membranes, to the action of ultraviolet or visible radiation);
• angioedema (edema of Quincke);
• retention of urine;
• increased sweating, chills;
• general weakness;
• the feeling of a rush of blood to the face;
• alopecia (baldness);
• aggravation of the course of bronchial asthma.

Contraindications

• hypersensitivity to doxepin;
• glaucoma (increased intraocular pressure above a tolerated level for a given person, followed by the development of typical visual field defects, decreased visual acuity and optic nerve atrophy.);
• adenoma (benign tumor) of the prostate;
• acute myocardial infarction;
• left bundle branch blockade, 3rd degree atrioventricular block;
• severe impairment of renal, hepatic and hematopoietic system function;
• pregnancy, lactation (breastfeeding);
• children's age (up to 12 years).

Application in pregnancy and lactation

Doxepin is contraindicated in pregnancy and lactation.

Use in children

Contraindicated in children under 12 years.

special instructions

With a sudden cessation of long-term treatment, there may be a withdrawal syndrome, manifested by nausea, headache, and general weakness.

In case of an overdose, drowsiness, stupor, visual impairment, dry mouth, respiratory depression, arterial hypotension, coma, convulsions, tachycardia, arrhythmias are possible.

During the treatment, alcohol (ethanol) is contraindicated.

Impact on the ability to drive vehicles and manage mechanisms

In the treatment of Doxepin, special care should be taken when driving a car, servicing machinery, and performing work that requires increased concentration.

Drug Interactions

With simultaneous use with anticholinergics, anticholinergic effects may be enhanced.

With the simultaneous use of Doxexin in doses of more than 200-250 mg, it is possible to reduce or completely inhibit the antihypertensive action of guanethidine or preparations with a similar mechanism of action.

With simultaneous use with dextropropoxyphene, the oppressive effect on the CNS may be increased; with lithium carbonate - possible manifestations of neurotoxicity.

In patients with diabetes mellitus, when combined with doxepin and tolazamide, development of severe hypoglycemia is possible.

With simultaneous application with chlorpromazine, hyperpyrexia can develop.

With simultaneous use with cimetidine, an increase in the concentration of doxepin in the blood plasma, an increase in its main effect, as well as an anticholinergic side effect.

With simultaneous use with ethanol (alcohol), concentration of attention is disturbed and the speed of psychomotor reactions decreases.

Analogues of the drug Doxepin

Structural analogs for the active substance:

• Sinekwan.

Analogues of Doxepine in the pharmacological group (antidepressants):

• Adress;
• Azafen;
• Azona;
• Alventa;
• Aleval;
• Amizole;
• Amitriptyline;
• Asentra;
• Aurorix;
• Brintellix;
• Valdoxane;
• Velaxin;
• Venlafaxine;
• Vokssel;
• Gelarium;
• Heparett;
• Heptor;
• Daplex;
• Deprefalt;
• Deprim;
• Duloxetine;
• Zoloft;
• Ixelles;
• Imipramine;
• Kaliksta;
• Clomipramine;
• Coaxyl;
• Lenuksin;
• Lyudomil;
• Maprotibene;
• Miansan;
• Miracitol;
• Mirzaten;
• Neuroplant;
• Noxibel;
• Newvelong;
• Oprah;
• Paxil;
• Paroxetine;
• Plizil;
• Portal;
• Prodep;
• Rexetin;
• Remeron;
• Selektra;
• Sirleft;
• Sinekwan;
• The Siozam;
• Stimuloton;
• Thorin;
• Umorap;
• Févarine;
• Floxet;
• Fluxonil;
• Flunisan;
• Fluoxetine;
• Framex;
• Cipralex;
• Cipramyl;
• The citalift;
• Citalopram;
• Citol;
• Elivel;
• Elicia;
• Esprital;
• Escitalopram;
• Ephevelone.

Review of the neurologist's doctor

The drug Doxepine well relieves depressive and anxious states in elderly patients with pre-acute and senile psychoses. Usually, it is enough to prescribe a medicine for 1 capsule of 25 mg three times a day. There were in my practice side reactions to Doxepin therapy, manifested by drowsiness, dyspnoea, dizziness. In addition, I prescribe this drug as part of complex therapy for patients with chronic alcoholism for the management of depressive episodes and mild delusional syndromes.

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