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Doxepin is a tricyclic compound, specifically a dibenzoxepin, and possesses three rings fused together with a side chain attached in its chemical structure. [48] It is the only TCA with a dibenzoxepin ring system to have been marketed. [72] Doxepin is a tertiary amine TCA, with its side chain-demethylated metabolite nordoxepin being a secondary ...
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]
Venlafaxine has also been implicated to create withdrawal symptoms regardless of dosage. [15] Venlafaxine has been implicated in causing the most severe withdrawal symptoms after cessation of use, possibly due to its short half-life. [16] To simplify identifying the principal signs and symptoms, the mnemonic FINISH may be used: Flu-like ...
Tricyclic antidepressants, such as desipramine (Norpramin), doxepin, imipramine (Tofranil), nortriptyline (Pamelor) and protriptyline, and tetracyclic antidepressants, such as mirtazapine (Remeron).
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.
Where risks or harms is the reason for withdrawal, this will usually have been prompted by unexpected adverse effects that were not detected during Phase III clinical trials, i.e. they were only made apparent from postmarketing surveillance data collected from the wider community over longer periods of time.
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]
Generally, tapering is done is to avoid or minimize withdrawal symptoms that arise from neurobiological adaptation to the drug. [1] [2] Prescribed psychotropic drugs that may require tapering due to this physical dependence include opioids, [3] [4] [5] selective serotonin reuptake inhibitors, [6] antipsychotics, [7] anticonvulsants, [8] and ...