Doxepin is a drug that belongs to the group of tricyclic antidepressants. It is a white crystalline powder that dissolves well in water, worse in chloroform and alcohol.
Doxepin is available in capsules with a dosage of 10 and 25 mg of active substance in blisters, each containing 15 tablets, and in one box - two blisters.
One capsule of medicament contains 10 or 25 mg( depending on the form of release) of doxepin hydrochloride.
Contents
- Pharmacological profile
- Mechanism of action
- Scope and contraindications
- Application and dosage aspects
- Cases of overdose and side effects
- Special instructions
- Interaction with other drugs
- Practical experience with
- Purchase and storage of medication
Pharmacological profile
This drug has a complex effecton the body. First of all, this antidepressant, sedative, antipanic, antipruritic and analgesic effect. Also, the drug is able to have a calming and alpha-adrenoblocking effect. The active component of the drug contributes to retardation of intraventricular conduction.
Prolonged medication stabilizes serotonergic and adrenergic spread, which is disrupted by
The structural formula of doxepin hydrochloride
is the onset of a depressed state. The drug is particularly effective in the case of bulimia of neurologic origin, accompanied by depression. Reduces the likelihood of vegetative manifestations in the background of neurotic disorders.
The components of the preparation are completely and quickly absorbed in the digestive tract. The greatest of its saturation in the blood plasma is observed 2-3 hours after ingestion. The therapeutic molarity of the drug in an amount of about 50-150 μg / ml is achieved after two weeks. The active substance of the drug is able to penetrate into the mother's milk through the placental barrier. The process of demethylation in the liver goes to demethylidoxepine.
The elimination half-life is on average 8-24 hours. The components of the drug are excreted in the urine in the form of metabolites. The ability to bind to plasma proteins is 76%.The main active metabolite( noroxepine) is excreted from the body for 33-80 hours.
Mechanism of action
The mechanism of action of the drug is the effect on adrenergic migration in the central nervous system. Also, the active substance blocks the neuronal seizure of norepinephrine. The drug has no stimulating effect on the central nervous system and does not inhibit MAO.
After taking the medication, the anxiolytic effect initially manifests itself. After 2-3 weeks of use, the optimal antidepressant effect comes.
Scope and contraindications
Indications for use Doxepine:
- manic-depressive psychosis;
- pre-acute depression;
- panic disorder;
- melancholy, agitation and a sense of fear;
- skin itching on the background of idiopathic cold urticaria;
- manifestation of pains of a neurogenic nature( rheumatoid, atypical pain in the face, migraine);
- peptic ulcer disease of the stomach and duodenum;
- sleep disturbance;
- anxiety and neuroses;
- anxiety on the background of alcohol dependence;
- is a premedication before conducting minimally invasive procedures for which general anesthesia is not applied.
Medication is contraindicated in the following cases:
- presence of glaucoma;
- blocking the left bundle branch leg;
- sensitivity to the constituent components of the drug;
- for children up to the age of twelve;
- pregnancy and lactation period;
- manifestation of allergic reactions to drugs;
- administration of monoamine oxidase inhibitors within the last fourteen days;
- thyroid hyperactivity;
- presence of kidney and liver diseases;
- presence of diabetes mellitus.
Application and dosage details
Medication capsules are prescribed for internal administration. The daily dose of the drug is 40-300 mg. A dose of up to 100 mg can be consumed at a time.
Doses exceeding the amount of 100 mg should be taken in three divided doses. The largest single dose should not be more than 100 mg( taken before bedtime).
When a severe symptom of depressive and anxious conditions develops, the usual initial dose is 75 mg. For most patients, this amount of medication is sufficient. With advanced and chronic forms of illness, the dose should be increased to 300 mg, with a three-fold increase in the frequency of administration.
Patients in advanced age should take one second of the usual recommended dose of Doxepin.
Cases of overdose and side effects of
In case of an overdose, symptoms of such symptoms as: psychomotor agitation, ataxia, inhibition and reflex increase are possible.
Other side effects may also occur:
- urticaria and angioneurotic edema;
- infringement of the endocrine system( enlargement of the mammary glands, abnormal liver and kidney function, gynecomastia and abnormal carbohydrate metabolism);
- myasthenia gravis, paresthesia and increased manifestation of epileptic seizures;
- hemorrhagic vasculitis and cytopenia;
- increased depressive state, the occurrence of psychotic disorder and hallucinatory symptoms;
- confusion with the occurrence of mental and mnestic disorders.
Special instructions
During the course of treatment with Doxepin, it is necessary to control peripheral blood( in some cases, agranulocytosis may occur).
In the presence of liver or kidney disease, the drug is prescribed only when absolutely necessary. With prolonged therapy, the work of these organs should be constantly monitored. It is not recommended to take the medication during pregnancy and lactation, since the active substance is able to penetrate the placenta and mother's milk.
In therapy, it is not recommended to drink alcohol, as this can lead to side effects. Also, the drug is not prescribed for children under the age of twelve. During treatment it is recommended to take care when driving and other activities that require concentration.
Interaction with other
preparations Parallel administration of Doxepin with anticholinergic drugs leads to an increase in their effect. Joint use with Dextropropoxyphene increases the depressing effect on the central nervous system.
Parallel reception with lithium carbonate leads to the appearance of neurotoxicity. With simultaneous use with ethanol, the speed of psychomotor reactions decreases and the ability to concentrate attention is impaired.
Practical experience of application of
Reviews of doctors and patients who took or take Doxexin tablets.
I usually prescribe this drug for depressive conditions, but I spend the therapy in short courses, as it can become addictive.
Valery Stepanovich( doctor of psychotherapist)
Almost all of my patients I prescribed Doxexin complained of side effects in one or another quantity. According to my observations, I can say that everything depends on the degree of development of anxiety, depression, panic and other psychiatric disorders.
When the conditions are running, the drug is not always effective.
Evgeny Sergeevich( doctor psychotherapist)
I took this drug for one month. I did everything according to the doctor's instructions( although I was very much afraid that there would be some undesirable phenomena) and everything went well. I took three times a day with a daily dose of 150 mg.
Anna
I treated this drug with my depression. I became so inhibited that it affected my efficiency. The course of treatment has brought to an end, I do not even know if it was a side effect from the reception or it is such a therapeutic effect.
Alexander
Practice and feedback from patients show that the drug is not always effective in all cases. The appearance of adverse reactions and the onset of a therapeutic effect depends on the individual characteristics of the organism.
Purchase and storage of
Doxexin is available in capsules with a white crystalline powder, the average price for this medication is 500-550 rubles.
The preparation should be stored in a dry and dark place, at room temperature. Shelf life of the medicine is three years from the date of 
production.
This medication is dispensed only on the prescription prescribed by the doctor.
Analogues of Doxepin, which are available for purchase in the Russian Federation:
- Anafranil;
- Amitriptyline;
- Ludomyl;
- Clofranil;
- Saroten;
- Melipramine;
- Elivel.
