Sinequan (Doxepin)

Sinequan is used to elevate the mood of patients with depression. Nortriptyline is also a sedative and is useful in depressed patients with insomnia, restlessness, and nervousness. It also has been found to be helpful for treating chronic pain and the pain of neuralgia.

The dose of sinequan is tailored to the patient's needs. Sometimes, physicians will start with relatively low doses, such as 25mg, given three times a day, to reduce the risk of excessive sedation early in the course; doses then will be increased slowly. (It may take several weeks before the effects of a dose are maximal.) Other physicians prefer to give nortriptyline once daily, in which case it is generally given at bedtime to take advantage of its sedating properties. Elderly persons and patients with advanced liver disease may need lower doses.

Sinequan is an anti-depressant medication of the tricyclic class. Medications in this class are often referred to as tricyclic anti-depressants, or TCAs. Depression is an all-pervasive sense of sadness and gloom. In some patients with depression, abnormal levels of neurotransmitters (chemicals that the nerve cells use to communicate with each other) may be the cause of the depression. Nortriptyline elevates mood by raising the level of neurotransmitters in the brain.

If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

Sinequan should be stored below 86 degrees F (30 degrees C) in a tight, light resistant container.

There is very little information about the effects of sinequan on the fetus in pregnant women. Physicians may use sinequan it if its benefits are deemed to outweigh the unknown risks. It is not known if doxepin is secreted in breast milk.

The most commonly encountered side effects associated with sinequan include rapid heart rate, blurred vision, urinary retention (difficulty urinating), dry mouth, constipation, weight gain or loss, and low blood pressure when going from sitting to standing orthostatic hypotension). Rash, hives, seizures, and hepatitis are rare side effects. Sinequan also can cause elevated pressure in the eyes of some patients with glaucoma. Overdose with sinequan can cause life threatening abnormal heart rhythms or seizures. If antidepressants are discontinued abruptly, symptoms may occur such as dizziness, headache, nausea, changes in mood, or changes in the sense of smell, taste, etc. (Such symptoms even may occur when even a few doses of antidepressant are missed.) Therefore, it is recommended that the dose of antidepressant be reduced gradually when therapy is discontinued.

Do not share this medication with others. Keep all medical appointments.

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