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Doxepin is a mixture of and stereoisomers with an approximate ratio of 85:15. [5] When doxepin was developed, no effort was made to separate or balance the mixture following its synthesis, resulting in the asymmetric ratio. [5] (Z)-Doxepin is more active as an inhibitor of serotonin and norepinephrine reuptake than (E)-doxepin. [5]
The antidepressant drug doxepin has been associated with a number of different adverse effects, including the following. [1] [2] [3] The incidence of these adverse effects is not totally known as the scarcity of well-designed clinical trials involving doxepin prohibits it.
This is a complete list of clinically approved prescription antidepressants throughout the world, as well as clinically approved prescription drugs used to augment antidepressants or mood stabilizers, by pharmacological and/or structural classification.
The first-generation sedating antihistamines diphenhydramine, doxepin, doxylamine, and pyrilamine are the most widely used medications in the world for preventing and treating insomnia. [6] As of 2004, doxylamine and diphenhydramine, which are both over-the-counter medications, were the agents most commonly used to treat short-term insomnia. [ 11 ]
Total exposures to both doxepin and nordoxepin differ by almost 10-fold in CYP2D6 ultra-rapid versus poor metabolizers. [3] Both doxepin and nordoxepin are also transformed into glucuronide conjugates. [3] The elimination half-life of nordoxepin is approximately 31 hours, which is almost twice that of doxepin (mean 17 hours). [1]
Depakote (valproic acid/sodium valproate) – an antiepileptic and mood stabilizer used to treat bipolar disorder, neuropathic pain and others; sometimes called an antimanic medication.
Brexpiprazole, sold under the brand name Rexulti among others, is an atypical antipsychotic medication used for the treatment of major depressive disorder, schizophrenia, and agitation associated with dementia due to Alzheimer's disease.
Here are links to possibly useful sources of information about Doxepin. PubMed provides review articles from the past five years (limit to free review articles ) The TRIP database provides clinical publications about evidence-based medicine .