Doxepin

Doxepin is a tricyclic antidepressant marketed worldwide. Brand names of oral formulations include Deptran and Sinequan, and brand names of topical (cream) formulations include Prudoxin.

Medical uses

Doxepin is used to treat depression, anxiety disorders, pruritus, insomnia, and as a second-line treatment of chronic idiopathic urticaria (hives). Its oral formulations are FDA-approved for the treatment of depression, anxiety, and insomnia and its topical formulations are FDA-approved the short-term management (up to 8 days) of atopic dermatitis and lichen simplex chronicus. Whereas in Australia and the UK, the only licensed indication(s) is/are in the treatment of major depression and of major depression and pruritus in eczema, respectively.

Pregnancy and lactation

Its use in pregnant and lactating women is advised against, although the available preclinical (based on animal studies) evidence suggests it is unlikely to cause any deleterious effects on fetal development. The lack of evidence from human studies, however, means it is currently impossible to rule out any risk to the fetus and it is known to cross the placenta. Doxepin is secreted in breast milk and neonatal cases of respiratory depression in association with maternal doxepin use have been reported.