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]]