Doxepin

Doxepin is a medication used to treat major depressive disorder, anxiety disorders, chronic hives, and trouble sleeping. For hives it is a less preferred alternative to antihistamines. It has a mild to moderate benefit for sleeping problems. It is used as a cream for itchiness due to atopic dermatitis or lichen simplex chronicus. Doxepin is a medication used to treat major depressive disorder, anxiety disorders, chronic hives, and trouble sleeping. For hives it is a less preferred alternative to antihistamines. It has a mild to moderate benefit for sleeping problems. It is used as a cream for itchiness due to atopic dermatitis or lichen simplex chronicus. Common side effects include sleepiness, dry mouth, constipation, nausea, and blurry vision. Serious side effects may include suicide in those under the age of 25, mania, and urinary retention. A withdrawal syndrome may occur if the dose is rapidly decreased. Use during pregnancy and breastfeeding is not generally recommended. Doxepin is a tricyclic antidepressant (TCA). While how it works for treating depression is unclear, it may involve increasing the levels of norepinephrine, along with its antihistamine, anticholinergic, and antiserotonergic effects. Doxepin was approved for medical use in the United States in 1969. It is available as a generic medication. A month supply in the United Kingdom costs the NHS at least 100 £ as of 2019. In the United States the wholesale cost of this amount is about US$23. In 2016 it was the 239th most prescribed medication in the United States with more than 2 million prescriptions. Doxepin is used as a pill to treat major depressive disorder, anxiety disorders, and chronic hives, and for short-term help with trouble remaining asleep after going to bed (a form of insomnia). As a cream it is used for short term treatment of itchiness to due atopic dermatitis or lichen simplex chronicus. In 2016 the American College of Physicians advised that insomnia be treated first by treating comorbid conditions, then with cognitive behavioral therapy and behavioral changes, and then with drugs; doxepin was among those recommended for short-term help maintaining sleep, on the basis of weak evidence. The 2017 American Academy of Sleep Medicine recommendations focused on treatment with drugs were similar. A 2015 AHRQ review of treatments for insomnia had similar findings. A 2010 review found that topical doxepin is useful to treat itchiness. A 2010 review of treatments for chronic hives found that doxepin had been superseded by better drugs but was still sometimes useful as a second-line treatment. Known contraindications include: Its use in pregnant and lactating women is advised against, although the available evidence suggests it is unlikely to cause negative effects on fetal development. The lack of evidence from human studies, however, means it is currently impossible to rule out any risk to the fetus and it is known to cross the placenta. Doxepin is secreted in breast milk and neonatal cases of respiratory depression in association with maternal doxepin use have been reported.