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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]
Doxepin Dosage for Sleep. Doxepin is typically prescribed for insomnia at a dosage of 3 to 6 milligrams per night. Interestingly, the medication appears to be effective even at a very low dose.
The combination of doxylamine and pyridoxine is available in the form of extended-and delayed-release oral tablets containing 10 to 20 mg doxylamine succinate and 10 to 20 mg pyridoxine hydrochloride. [22] Doxylamine alone is available over-the-counter, whereas doxylamine in combination with pyridoxine is a prescription-only medication. [22]
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.
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.
Dosulepin, also known as dothiepin and sold under the brand name Prothiaden among others, is a tricyclic antidepressant (TCA) which is used in the treatment of depression. [4] [6] [7] Dosulepin was once the most frequently prescribed antidepressant in the United Kingdom, but it is no longer widely used due to its relatively high toxicity in overdose without therapeutic advantages over other TCAs.
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 .