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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by Carter on March 1, 2000, at 9:10:31
Hey everybody-
I know it's a tired way to use this list, but I'm seeing my pdoc today,
and considering bringing up Doxepin (I find its' profile very appropriate for me).
In the event that anyone's tried it, could you share your experience (w/ the appropriate background information)?
I'd appreciate it. Have a good day, folks-
Carter
Posted by Carter on March 1, 2000, at 9:29:27
In reply to Doxepin (Sinequal/Adapin) qx to list, posted by Carter on March 1, 2000, at 9:10:31
Sorry-
That's Sinequan, not Sinequal.
I'm also having a hard time finding a monograph detailing its absorption details- half-life, peak plasma conc.? Hmm..
Thanks again,
Carter
Posted by Richard on March 1, 2000, at 13:55:39
In reply to Re: Doxepin (Sinequan/Adapin) qx to list, posted by Carter on March 1, 2000, at 9:29:27
> Sorry-
> That's Sinequan, not Sinequal.
> I'm also having a hard time finding a monograph detailing its absorption details- half-life, peak plasma conc.? Hmm..
> Thanks again,
> CarterHalf-life is usually given as 8-16 hours, probably somewhat less than amitriptyline. It is sedating as it is the most powerful H1 blocker available, but less anti-cholenigeric than amitriptyline. Useful in many for sleep with less side effects than amitriptyline. Good for anxiety.
Posted by saint james on March 1, 2000, at 16:53:32
In reply to Re: Doxepin (Sinequan/Adapin) qx to list, posted by Richard on March 1, 2000, at 13:55:39
> > Sorry-
> > That's Sinequan, not Sinequal.
> > I'm also having a hard time finding a monograph detailing its absorption details- half-life, peak plasma conc.? Hmm..
> > Thanks again,
> > Carter
>
> Half-life is usually given as 8-16 hours, probably somewhat less than amitriptyline. It is sedating as it is the most powerful H1 blocker available, but less anti-cholenigeric than amitriptyline. Useful in many for sleep with less side effects than amitriptyline. Good for anxiety.
James here....I took Doxepin from 1985-1995 alone (1985-1992) and then with Exxexor at doses of 100mg to 300 mg though generally 100-150mg. It is my usderstanding that with all TCA's to lower limit is 75 mg. Doxepin is the most sedating TCA seems to be the most potent H1 blocker (meaning it is one hell of an antihistanine) and to me is also very anticolonergic (I have taken many of the TCA's but not amitriptyline) Doxepin is also used by allergists for hives and severe allergic reactions; as I have severe allergies I take Doxipin when allergies get bad. When I first took it 75 mgs knocked me flat on my ass, but after a few day this lessened and after 2 week the level of sedation was perfict. The amoung od drying may me too much for many but I have always found that in matters of sedation, antihistamic, or anticolonergic side effects they alway get less with time. The first week is hell for some.
Nothing will happen for 4 weeks...this rule is esp. true of the TCA's but the antianxiety effects happen at once and this is a great relief. I experienced a very roubust AD effect at about 5 weeks. It came on quickly in the space of 1 day. Wham ! As soon as I realized I was not depressed I realized several things 1) I was pretty depressed b4 2) I used to feel like this but must have forgotten what normal felt like
3) My depression had creeped up on me over 2 years so I never knew it happened.Dosages....there is a lower limit, generally stated as 75 mgs but for me it was 100 mgs. A did go to 300 mgs but I was dealing with some heavy psychological issues at that point. Above 150 mgs was just too sedating if I was to go to school or work.
Doxipin worked well for me for many years and I general I am a happy camper 360 days of the year. Doxipin pooped out starting in 1990-91 but I don't equate this to the med I was on but to all AD's. The TCA are often called "dirty drugs" because they effect many pathways. In the case of Doxipin, 5HT (to a greater amount) and nor-E, along with the colonergic and H1 pathways. Ofetn in depression a dirty drug works better than a clean one because mood is a complex thing. Any model we use today is flawed because neurology is
very complex and we really do not understand it.
The TCA's are still the gold standard with which other AD are measured. 70 % of depressives given a TCA will recover. Most TCA's are generic.Flating of the effect is reported in TCA's. I would describe it as having 1 mood all the time.
Doxipin can really make you flat at the higher doses; at 300 mgs I felt very 2-D, I was going thru a lot so this was the desired effect. This side effect is dose related.TCA's are great for sleep. I can't remember the last time I had a bad nights sleep. This is a great comfort and the benifits of really good sleep and mood, health, and attention are many.
I feel the TCA's should be used a sleep aids more often as first line meds instead of the benzo's.
For me, benzos are great for sleep but after 1 week it is just drugged sleep which leaves me tired all day and sleepy. It has been reported that TCA's increase REM sleep. My impression is that TCA's tend to make one remember dreams more and that the dreams are more intense. My dreams are fun so I enjoy this effect.Contipation and urinary retention do happen on TCA's and esp Doxipin. The anticolonergic effect accounts for this. At first it is hard to start peeing, which is very anoying ! These will pass.
I would start with 25 mgs (take 2-3 hrs b4 bedtime) and work up slowly letting the amound of
sedation be your guide. Once you are used to it
a good guide to amount is enough to give good sleep.james
Posted by saint james on March 1, 2000, at 17:02:21
In reply to Re: Doxepin (Sinequan/Adapin) qx to list, posted by Carter on March 1, 2000, at 9:29:27
> Sorry-
> That's Sinequan, not Sinequal.
> I'm also having a hard time finding a monograph detailing its absorption details- half-life, peak plasma conc.? Hmm..
> Thanks again,
> CarterJames here....
Forgot to add that this is common (no monograph) as most TCA's have been out for decades and aer now generic. Got to the library and consult the PDR....or go to the Rx and ask for the insert they get with each bottle.
james
This is the end of the thread.
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