Home > Drugs A – Z > Doxepin (By mouth)

Doxepin (By mouth)

Treats depression, anxiety, and sleep disorders. This medicine is a TCA.

What works?

Learn more about the effects of these drugs. The most reliable research is summed up for you in our featured article.

Doxepin is used to treat anxiety or depression. It is also used to treat insomnia (trouble with sleeping). Doxepin is a tricyclic antidepressant (TCA). It works on the central nervous system (CNS) to increase levels of certain chemicals in the brain. This medicine is available only with your doctor's prescription… Read more
Brand names include
Silenor
Other forms
On the skin
Drug classes About this
Antianxiety, Antidepressant, Antiulcer, Sleep Aid

What works? Research summarized

Evidence reviews

Effectiveness and safety of doxepin for primary insomnia: a systematic review

Bibliographic details: Yuan JQ, Yang KH, Liu YL, Yang SP.  Effectiveness and safety of doxepin for primary insomnia: a systematic review. Chinese Journal of Evidence-Based Medicine 2010; 10(11): 1325-1330

Doxepin for insomnia: a systematic review of randomized placebo-controlled trials

Doxepin, a sedating tricyclic drug, at 3 mg and 6 mg doses was recently approved by the U.S. food and drug administration (FDA) for the treatment of insomnia. The objective of this systematic review was to obtain a precise summary of the efficacy and safety of doxepin as a hypnotic. We searched key databases and trial registers up to March 2014 and contacted pharmaceutical companies and the FDA for unpublished data. A total of nine randomized placebo-controlled trials were analyzed. Six studies were on doxepin 1-6 mg/d, two on doxepin 25-300 mg/d, and one on ramelteon 8 mg and doxepin 3 mg combined. All low-dose studies were industry-sponsored. We found that low-dose doxepin had a small to medium effect size against placebo for sleep maintenance and sleep duration but not for sleep initiation at both immediate and short-term posttreatment. There was no significant next-day residual effect with low-dose doxepin. Headache and somnolence were the most common side effects. We concluded that low-dose doxepin for 1-2 nights appeared to be safe and effective in improving sleep. However, a clear conclusion on its short-term benefits and risks as well as withdrawal effects was not possible due to the small number of studies.

Use of ultra-low-dose (</=6 mg) doxepin for treatment of insomnia in older people

BACKGROUND: Insomnia is one of the most frequent complaints encountered in primary care practice, one that results in significant clinical consequences and cost burden to the public health system. It is more common in elderly adults (≥65 years of age), with frequent complaints regarding sleep maintenance and early morning wakening. Current treatment options have limitations. This review was conducted to evaluate the evidence behind ultra-low-dose doxepin in insomnia and to discuss its potential advantages, its place in therapy and its implications in practice in the treatment of older patients.

See all (42)

Summaries for consumers

Interventions for people with schizophrenia who have too much saliva due to clozapine treatment

Clozapine is an antipsychotic medication used in the treatment of schizophrenia, a mental health problem that can cause symptoms such as hallucinations and delusions and social withdrawal. Clozapine may be useful in those for whom other medications have not worked very well. One of the common side‐effects of clozapine is having too much saliva in the mouth (hypersalivation). This can be embarrassing in public and problematic, especially at night. This review is about ways of reducing this problem and includes 15 trials containing 964 people, most of which were done in hospitals in China. Treatments included medications that had previously been useful for this problem or were thought to work in theory. The medications used were from a group of drugs called antimuscarinics, traditional Chinese medicines or others. The trials were short (all four weeks or less). From these trials the antimuscarinics; astemizole, diphenhydramine and propantheline, were shown to be better than placebo at reducing hypersalivation. Another medication called oryzanol and a Chinese traditional medicine called Suo quo wan were found to have benefit over doxepin, an antimuscarinic. However, because of the shortness of the trials, poor reporting and the limitations of design, it is difficult to draw any firm conclusions from these results. 

Treatment for fatigue in Parkinson's disease

At least one‐third of people with Parkinson's disease complain about fatigue. It is unclear what treatment is best to reduce fatigue in people with Parkinson's disease.

Do pharmacotherapies which reduce anxiety help smokers to quit

Anxiety can contribute to increased smoking, and may be a smoking withdrawal symptom. Medications to reduce anxiety (anxiolytics) may theoretically help smokers trying to quit. There have not been many trials, and none of them showed strong evidence of an effect on quitting.

See all (5)

PubMed Health Blog...

read all...