Doxepin

Chemical name

3-Дибенз[b,e]оксепин-11(6H) -илиден-N,N-диметил-1-пр��панамин (as hydrochloride)

Gross

C19-H21-N-O

Characteristics

The white crystalline powder. It is soluble in water, worse, in alcohol and chloroform.

Of drugs

Drugs, the antidepressant, anxiolytic, sedative, protivoyazvennoe. Ters of adrenergic neurotransmission in the central nervous system, blocking reverse takeover norarenalina. And antiholinergicakim, antiserotoninovm and antigistaminnam action. Quickly and completely absorbed in the digestive tract, is metabolized in the liver, with the participation of zitohroma P450 2D6 to pharmacologically active demetil-doksepina further glukuronidiruetsa and excreted in urine, T_1/2 - 28-52 hours; Spread the fabric, it is found, particularly in the lung, heart, brain, liver. Answers depression, improves mood, eliminates apathy, depression, the state of internal tension and fear. It has therapeutic effect on vegetative violations Neurotic origin. Clearly antidepressant effect was evident in 2-3 weeks of admission. And spazmoliticescoy activity moderate sossoudorasshiratm flaccid, and miorelaksirutm protivosudorojnam influence; Discourages CNS not ingibiruet MAO.

Indications

Depression, anxiety and insomnia, with nervousness, alcoholism, organic diseases of CNS, psychoneurotic disorders with anxiety, depression, psychotic disorders (including inwalutinaya, реактивно-депрессивн��я phase �аниакально-депрессив ного psychosis). As of general practice, saying the disease duodenal ulcer, demping-sindrom, pre syndrome, chronic pain in cancer patients, itchy skin, chronic idiopathic urticaria.

Contraindications

Hypersensitivity, zakratougolnaya glaucoma, AV blockade adenoma cancer, pregnancy, breast-feeding (should abandon breastfeeding), children's age (up to 12 years).

Side-Effects

Brown mouth, nausea, vomiting, anorexia, the violation of taste sensations, mouth disease, diarrhoea, constipation, urine retention, impaired vision, general weakness, a sense of the tide of blood to a person, dizziness, noise in the ears, headache, drowsiness, disorientation, hallucinations, parestesia, ataxy, ekstrapiramidnye violations, convulsions, tremor, hypotension, tachycardia, photosensitization, allergic reactions (skin rash, itching, swelling angioneuroticeski, eozinofilia); rarely lakopenia, agranulozitos, thrombocytopenia, increases or decreases libido, testicular swelling, ginekomastia (men), an increase in mammary glands, galactorea (women), or hypothetical giperglikemia, inadequate syndrome secreta antidiuretic hormone, alopecia.

Patient interaction

Zimetidin increases in the concentration of plasma and magnifies the effect. The diabetics in the sharing of the tolazamidom possible development gipoglikemii expressed. Chlorpromazine increases the likelihood giperpirexii development.

Overdosing

Fall, stalemate, hallucinations, impaired vision, the pupils, dry mouth, nausea, respiratory depression, severe arterial gipotenzia, coma, convulsions, muscle rigidity, tachycardia, arrhythmia characteristic of intoxication tricyclic antidepressants ECG changes (especially Micro).

Precautions

If long-term care is not recommended sudden stop because of the risk of the syndrome (nausea, headache, weakness); Should not engage in activities in which there is a need for increased speed of mental and motor reactions; In the period of treatment is not allowed alcohol, the use of MAO inhibitors.

Dosing and Administration

Inside, and expressed moderate depression and / or anxiety appoint 75 mg / day, then picked individually effective dose (usually 75-150 mg / day). With substantial symptoms of depression and anxiety are effective dose is 300 mg / day; In patients with the lowest expressed violations effective dose-25-50 mg / sut. Daily dose taken for 1-2 times (single dose should not exceed 150 mg). In sleep disorders most of the daily intake are evening; The average length of treatment is 2-3 weeks.

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