Dosulepin hydrochloride
2553390
219882823
2008-06-17T08:30:04Z
Scampo
2697405
Punctuation
{{Unreferenced|date=October 2007}}
<br/>
{{Drugbox|
|IUPAC_name = 11-(3-Dimethylaminopropylidene)-6,-11- dihydrodibenz [b,e]thiepin hydrochloride
| image=Dosulepin.svg
| width=180
| CAS_number=113-53-1
| ATC_prefix=N06
| ATC_suffix=AA16
| ATC_supplemental=
| PubChem=13473
| DrugBank=
| C=19 | H=21 | N=1 | S=1
| molecular_weight = 331.9 g/mol
| bioavailability= 30%
| metabolism = [[Liver|Hepatic]]
| elimination_half-life=20 hours
| excretion = [[Kidney|Renal]]
| pregnancy_AU =
| pregnancy_US =
| pregnancy_category = C
| legal_status = Rx-only
| routes_of_administration= Oral
}}
'''Dosulepin hydrochloride''' ([[International Nonproprietary Name|INN]]) (formerly the [[British Approved Name|BAN]] '''dothiepin hydrochloride''') is an [[antidepressant]] of the [[tricyclic antidepressant|tricyclic]] family. It is sold under the brand names '''Prothiaden''', '''Dothep''' and '''Thaden'''.
==Indications==
Dosulepin is relatively mild and is used for low-level anxiety depression and similar disorders as well as the treatment of chronic and ongoing pain 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; it can also be combined with other drugs such as [[temazepam]].
==Dosage==
Adults: Initially 75 mg/day in divided doses or as a single dose at night, increasing to 150 mg/day. In certain circumstances, e.g. in hospital use or unresponsive patients, dosages up to 225 mg daily have been used.
Suggested regimens: 25 or 50 mg three times daily or, alternatively, 75 or 150 mg as a single dose at night. Should the regimen of 150 mg as a single night-time dose be adopted, it is better to give a smaller dose for the first few days.
Elderly: 50 to 75 mg daily initially. As with any antidepressant, the initial dose should be increased with caution under close supervision. Half the normal adult dose may be sufficient to produce a satisfactory clinical response.
Children: Not recommended.
<ref>[http://emc.medicines.org.uk/emc/assets/c/html/DisplayDoc.asp?DocumentID=8438 Prothiaden Tablets 75 mg , SPC from the eMC<!-- Bot generated title -->]</ref>
== Side effects ==
The most common side-effects are drowsiness and dry mouth as well as dry eyes. Other less common side-effects may include:
* [[Constipation]]
* Abnormally large [[stool]]s
* [[Blurred vision]]
* [[Tachycardia]]
* [[Urinary retention]]
* [[tremor]]s, especially of the hands
* Blood disorders
* [[Hypotension]]
* [[Sexual dysfunction]]
* [[Sweating]]
* Increased [[sensitivity to sunlight]]and increased vulnerability to sunburn
These side-effects cease when treatment ceases. Alcohol should be avoided whilst taking dosulepin as it may increase some side-effects.
Whilst dosulepin is not addictive, it should not be stopped suddenly as there is a risk of initial withdrawal symptoms which may be mistaken for some of the original indications for the drug:
* Nausea
* Vomiting
* Loss of appetite
* Headache
* Giddiness
* Chills
* Insomnia
* Anxiety
== Contra-indications ==
Contra-indications include:
* Certain conditions of the heart, mainly those affecting the electrical impulses to the heart muscle, particularly [[arrhythmia]] or recent [[myocardial infarction|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]]
==Drug interactions==
The drug can interact dangerously with [[vasoconstrictor]]s and should not be taken in combination with [[phenylephrine]] or [[adrenaline]] in particular.
The sedative effects of other CNS depressants (benzodiazepines such as diazepam and lorazepam, sedative antihistamines, opiates, etc.) may be increased.
This drug should not be started within 2 weeks of stopping a [[monoamine oxidase inhibitor]] (MAOI) antidepressant, and should not be co-administered with any selective [[serotonin reuptake inhibitor]] (SSRI) antidepressant such as [[fluoxetine]]), or 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 nor to be taken in combination with some other drugs, including herbal remedies.
==Overdose==
{{main|Tricyclic antidepressant}}
The symptoms and the treatment of an overdose are largely the same as for the other tricyclic antidepressants.
== References ==
<references/>
== See also ==
* [[Antidepressant]]
* [[Tricyclic antidepressant]]
<br/>
{{Antidepressants}}
[[Category:Tricyclic antidepressants]]
[[Category:Analgesics]]
[[ru:Амитриптилин]]