Antidepressants · TCAs
Doxepin
Brand: Sinequan (antidepressant doses), Silenor (ultra-low-dose insomnia)
Tricyclic antidepressant (TCA) / Dibenzoxepin
13 cards
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core (2)trap (2)dosing (1)risk (3)monitoring (2)interaction (2)population (1)
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1.Why is doxepin described as 'two different drugs'?
2.A patient on doxepin 6mg asks if she should worry about 'anticholinergic effects of TCAs.' How do you respond?
3.Doxepin 3mg vs 6mg for insomnia: what is the specific FDA indication?
4.At TCA doses, doxepin is lethal in overdose. What is the mechanism and emergency treatment?
5.What monitoring is required for doxepin at antidepressant doses (75-300mg) that is NOT needed at 3-6mg?
6.Doxepin is metabolized by CYP2D6. What happens if you co-prescribe with fluoxetine?
7.Why does doxepin work for sleep maintenance at just 3mg when diphenhydramine needs 25-50mg?
8.Draw the doxepin receptor engagement ladder by dose: which receptors engage at which doses?
9.When is doxepin at TCA doses (75-300mg) still clinically appropriate in modern practice?
10.A suicidal patient needs a TCA trial. What safety measure is critical regarding dispensing?
11.Doxepin's active metabolite desmethyldoxepin: what does it add clinically?
12.What baseline tests are required before starting doxepin at TCA (antidepressant) doses?
13.What ongoing safety concerns must you monitor with doxepin at TCA doses?
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