About doxepin

The exact cause of depression is not known. Depression can develop for no apparent reason or it may be triggered by a life event such as a relationship problem, bereavement, or illness.

Although it is not fully understood what causes depression, an imbalance of chemicals in our brain is thought to be a factor. Doxepin works by regulating the levels of chemicals called serotonin and noradrenaline in the brain; this eases the symptoms of depression.

Before taking doxepin

Before taking doxepin make sure your doctor or pharmacist knows:

• If you are pregnant, trying for a baby or breast-feeding.
• If you have thyroid problems.
• If you have liver problems.
• If you have epilepsy.
• If you have diabetes.
• If you have been constipated for several days.
• If you have any difficulties passing urine, or have had prostate trouble.
• If you have recently had a heart attack, or have any other heart problems.
• If you have ever had a mental health problem (such as bipolar disorder or psychosis).
• If you have glaucoma (increased pressure in the eye).
• If you have phaeochromocytoma (a tumour on your adrenal gland).
• If you have porphyria (a rare inherited blood disorder).
• If you are taking other medicines, including those available to buy without a prescription, herbal and complementary medicines. This is especially important if you have taken a treatment for depression, known as a monoamine-oxidase inhibitor (MAOI), recently.
• If you have ever had an allergic reaction to this or to any other medicine.

How to take doxepin

• Before starting this treatment, read the manufacturer's printed information leaflet from inside the pack.
• Take doxepin exactly as your doctor has told you.
• Doxepin can cause drowsiness, so your doctor may advise you to take a small dose when you first start taking doxepin and then to increase it gradually as your body gets used to it.
• Doxepin is usually given as a once-a-day dose at bedtime, although it may also be taken in smaller doses two or three times a day. Your doctor will have told you which is right for you and these directions will be on the label of the pack for you too.
• It is not important whether you take doxepin before or after food.
• Try to take doxepin at the same time(s) each day to avoid missing any doses.
• If you do forget to take a dose, take it as soon as you remember unless it is nearly time for your next dose, in which case leave out the missed dose. Do not take two doses together to make up for a forgotten dose.

Getting the most from your treatment

• You may feel that doxepin is not working for you straightaway. It can take a week or two after starting these capsules before the effect builds up and 4-6 weeks before you feel the full benefit. Do not stop taking it after a week or so, thinking it is not helping.
• Try to keep your regular appointments with your doctor. This is so your doctor can check on your progress.
• Do not drink alcohol while you are being treated with doxepin. Taking doxepin and alcohol will increase the chance that you experience side-effects.
• If you buy any medicines, check with a pharmacist that they are safe to take with doxepin.
• There are several types of antidepressants and they differ in their possible side-effects. If you find that doxepin does not suit you then let your doctor know, as another may be found that will.
• While you feel depressed or are taking doxepin, you may have thoughts about harming yourself or ending your life. It is very important that you tell your doctor about this if it happens.
• Your doctor will ask you to carry on taking doxepin after you feel better. You should expect that a normal course of treatment will last for around six months after your symptoms have eased.
• Doxepin may cause your skin to become more sensitive to sunlight than usual. Avoid strong sunlight and sunbeds until you know how your skin reacts.
• If you have diabetes you may need to check your blood glucose more frequently, as doxepin may affect the levels of sugar in your blood. Your doctor will be able to advise you about this.
• Do not stop taking doxepin unless your doctor tells you to do so. Stopping treatment suddenly can sometimes cause problems and your doctor may want you to reduce your dose gradually if this is necessary.

Can doxepin cause problems?

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. These usually improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.

If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist.

How to store doxepin

• Keep all medicines out of the reach and sight of children.
• Store in a cool, dry place, away from direct heat and light.

Important information about all medicines

References

• British National Formulary; 62nd Edition (Sep 2011) British Medical Association and Royal Pharmaceutical Society of Great Britain, London (link to current BNF)