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Re: Quick poll: Amitriptyline or Doxepin

Posted by ed_uk2010 on April 6, 2010, at 13:48:29

In reply to Quick poll: Amitriptyline or Doxepin, posted by tensor on April 6, 2010, at 13:35:41

> Which one would you choose for TRD with anxiety? Did well on nortrip once but pooped-out after a year, made me tired, too much NE? If not too much work, some pros and cons (if you have own experiences) for the two would be great!
>
> Thanks,
> Mattias

I wouldn't recommend doxepin for severe depression. It's mainly an antihistamine - a very strong one indeed! Very low doses are useful for chronic insomnia. It's also used to relieve itching eg. in urticaria or uncontrolled eczema. Doxepin is a very weak 5-HT/NE re-uptake inhibitor. It's not as well established for depression as other TCAs.

Amitriptyline is certainly an effective antidepressant but it's very sedating. Why not consider a less sedating tricyclic such as imipramine? Also, clomipramine causes some sedation but not as much as amitriptyline.

 

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