Dosulepin hydrochloride (sometimes known outside the USA as dothiepin hydrochloride) is an antidepressant of the tricyclic family. It is sold under the brand names of Prothiaden® and Thaden®.

Dosulepin is relatively mild and is used for low level anxiety depression and similar disorders, particularly where insomnia and/or loss of appetite are present. It can take between two and four weeks of regular usage to become effective, it is often started at a low level and the dosage increased if this is ineffective. The drug causes drowsiness as a side-effect, and this may be used as part of the treatment, since anxiety depressive patients may have difficulty sleeping, but it can be combined with other drugs such as temazepam.

It is recommended that patients on Dosulepin avoid alcohol while taking the medication as this may increase some side-effects.

Dosulepin is not addictive, but should not be stopped suddenly or without consulting your physician. There are potential side-effects from ceasing the drug.

Side-effects

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The commonest side-effects are drowsiness and dry mouth. Other less common side-effects may include:

• Constipation
• Blurred vision
• Tachycardia
• Urinary retention
• tremors, especially of the hands
• Blood disorders
• Hypotension
• Sexual dysfunction
• Sweating
• Increased sensitivity to sunlight, increased vulnerability to sunburn

These side-effects cease when treatment ceases.

Possible side-effects of aprupt withdrawal include:

• nausea
• vomiting
• loss of appetite
• headache
• giddiness
• chills
• insomnia
• anxiety

This list also includes some of the symptoms which are indications for the drug in the first place.

Contra-indications

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Contra-indications include:

• Certain conditions of the heart, mainly those affecting the electrical impuses to the heart muscle, particularly arrhythmia or recent heart attack
• Mania.
• Liver disease or thyroid disease
• Epilepsy, phaeochromocytoma glaucoma or diabetes
• Hypotension, vulnerability to dizziness or fainting
• History of urinary retention or porphyria

The drug can interact dangerously with vasoconstrictors and should not be taken in combination with phenylephrine or adrenaline in particular. Other specific contra-indications include monoamine oxidase inhibitor antidepressants (MAOI) (treatment should not be started until 2 weeks after stopping a MAOI); any selective serotonin reuptake inhibitor antidepressants (SSRI, e.g. fluoxetine); and any medication which affects the electrical impulses to the heart (e.g. astemizole, halofantrine or terfenadine).

The drug is not recommended for use by children, and you should always consult a doctor before taking this or any other medication. Dosulepin is not recommended to be taken in combination with some other drugs, including herbal remedies. Caution should be used when taking any over-the-counter medications in combination with Dosulepin; if in doubt consult your pharmacist or doctor.

Tricyclic antidepressants | Analgesics | Dotiepina | Амитриптилин