Adapin

The most common side effect of doxepin is drowsiness. Drowsiness improves as therapy continues. Other side effects associated with doxepin include:

• blurred vision,
• urinary retention (difficulty urinating),
• dry mouth,
• constipation,
• weight gain or loss,
• low blood pressure when rising from a sitting position (orthostatic hypotension),
• rash,
• hives,
• rapid or irregular heart rates,
• seizures, and
• hepatitis.

Doxepin also can cause elevated pressure in the eyes of some patients withglaucoma. Doxepin may dilate pupils which may trigger an angle closure attack in a patient with angle closure glaucoma.

If antidepressants, including doxepin, are discontinued abruptly, symptoms may include:

• dizziness,
• headache,
• nausea, and
• changes in mood.

Such symptoms of withdrawal may occur even when a few doses of antidepressant are missed. Therefore, it is recommended that the dose of antidepressant be reduced gradually when therapy is discontinued.

Antidepressants increased the risk of suicidal thinking and behavior in short-term studies in children and adolescents with depression and other psychiatric disorders. Anyone considering the use of any antidepressant in a child or adolescent must balance this risk with the clinical need. Patients who are started on therapy should be closely observed for clinical worsening, suicidal thinking or behavior, and unusual changes in behavior.

Tricyclic antidepressants , including doxepin, should not be taken with any of the monoamine oxidase inhibitor (MAOI) class of antidepressants (for example, isocarboxazid [Marplan], phenelzine [Nardil], tranylcypromine [Parnate], selegiline [Eldepryl], and procarbazine [Matulane]) or other drugs that inhibit monoamine oxidase such as linezolid [Zyvox] and intravenous methylene blue. Such combinations may lead to confusion, high blood pressure, tremor, hyperactivity, coma, and death. Doxepin should not be administered for at least 14 days after stopping.

Drug that affect heart rhythm such as amiodarone (Cordarone), bepridil (Vascor), and disopyramide (Norpace) should not be combined with doxepin since it also affects heart rhythm.

Cimetidine (Tagamet) increases the breakdown of doxepin by the liver and can increase doxepin blood levels, possibly causing side effects from doxepin.