Anxiety disorders affect nearly 40 million adults in the United States age 18 and older — a whole 18.1 percent of the population every year — making anxiety disorders the most common mental illnesses in the U.S., according to the Anxiety and Depression Association of America (ADAA). Many individuals with anxiety disorders may sometimes exhibit signs of depression as well or vice versa.
Sinequan (doxepin), a tricyclic antidepressant (TCA), looks to mitigate the effects of anxiety and depression, including but not limited to anxiety and depression associated with the misuse of alcohol. However, considering the class of this drug, misuse is a common outcome of treatment using doxepin if it is not monitored regularly, but there are ways to keep treatment in check and ensure minimal chances of substance misuse.
Sinequan is not only recommended for the treatment of psychoneurotic patients with depression and/or anxiety but also for depression and/or anxiety associated with alcoholism and/or organic disease. It is also indicated for psychotic depressive disorders associated with anxiety such as manic-depressive and involutional depression disorders. Some of the symptoms that the drug reacts well to include tension, depression, somatic symptoms and concerns, sleep disturbances, guilt, lack of energy, fear, apprehension and worry — to name a few.
Sinequan is a cyclic antidepressant, meaning it suppresses depression by working with the neurotransmitters used to communicate between brain cells, effecting changes in brain chemistry and nerve cell circuitry known to regulate mood. Thus, doxepin increases the norepinephrine and serotonin levels in the brain as a means of overriding feelings of depression and anxiety.
The drug is taken orally somewhere between one to three times daily, or as specifically indicated by your medical professional. For adults and children 12 years of age and older experiencing depression or anxiety, it may be directed that patients ingest 75 milligrams (mg) once a day or in divided doses throughout the day. The dose will typically not call for more than 150 mg per day. For patients being treated with insomnia, an average of 6 mg daily is the norm for adults. For older adults, a dose of 3 mg a day may suffice.
It is best not to take Sinequan within three hours of a meal as it can influence the efficacy of the drug and even make the patient sleepy going into the next day. If a dose is missed, take the missed dose as soon as possible, unless it is nearly time for the next dose.
It is crucial to consult your doctor before beginning treatment and before deciding to halt treatment to avoid misuse or inaccuracies in treatment.
Like any medication, certain side effects may come from treatment through doxepin. Of all the side effects, drowsiness is the one most frequent to occur, which is why doxepin has also been suggested to treat patients with insomnia. Other side effects include confusion, disorientation, numbness, paresthesia, extrapyramidal symptoms, seizures and tardive, among others.
Cyclic antidepressants are some of the most commonly ingested medications involved in a drug overdose. In fact, in 2016, tricyclic antidepressants were identified as one of the top 25 classes of medications associated with the greatest number of fatalities.
As mentioned previously, drowsiness is the most frequent of side effects. The initial symptoms of overdose may include anticholinergic manifestations like dilated pupils and increased heart rate but can progress further to seizures and cardiac arrest.
While doxepin has a higher rate of misuse than other medications on the market, misuse is not a guarantee for all patients. If monitored religiously, treatment with doxepin can yield positive results.
Sodium bicarbonate is just one of the additional chemicals that mitigates the likelihood of tricyclic antidepressant overdose. Also beneficial as part of treatment is gastric lavage as well as the incorporation of activated charcoal to help reduce the absorption of the ingested drugs. To be effective, you need 25-50g of activated charcoal before or after the gastric lavage. However, such additions should be incorporated into treatment immediately after consumption, as they tend to take some time to reach full effectiveness in lessening the toxicity of these kinds of drugs.
There are other precautious measures to take to ensure appropriate dosing and usage of doxepin, such as focus groups and peer-to-peer mentoring with those who have been through the many different stages of recovery. Recurrence of use is less of a sign of maltreatment or failure but rather a sign that treatment should be altered to better meet the needs of the patient for a more steady, efficient recovery process. Clinical treatment is only half the battle, but moral support and empathy are equally as pivotal to keeping such behaviors at bay.
The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.