Dosulepin: characteristics and side effects of this drug

This Antidepressant drug is marketed under names such as Altapin, Dothapax, Idom or Protiaden.

One of the most widely used antidepressants has been dosulepin, a drug that has been shown to be effective in treating both major depression and neurological problems.

This drug, which is obtained by prescription, has had its ups and downs, which is why its use has been decreasing in recent years, although it has not ceased to be prescribed.

Let's take a closer look at what are the characteristics of dosulepineWhat is dosulepine used for, in addition to discussing its adverse effects and contraindications.

Dosulepin: general characteristics.

Dosulepine, also known as dothiepin, is a tricyclic antidepressant, used in the treatment of depression.. It has been marketed under several names: Altapin, Depresym, Dopress, Dothapax, Dothep, Idom, Prepadine, Protiaden, Protiadene, Thaden, and Xerenal.

This psychotropic drug is available in various parts of Europe, New Zealand, Australia and Asia. Although it was one of the most prescribed antidepressants in the UK, this is no longer the case because it has a relatively high level of toxicity if overdosed, and it has no major advantages over the other tricyclic antidepressants.

Indications: what is it used for?

Dosulepin is used in the treatment of major depression. It is also used to treat pain of neurological origin, such as fibromyalgia, and as a preventive for migraines. There is scientific evidence that it is useful in treating atypical facial pain.

Mechanism of action

Dosulepin acts as a selective inhibitor of serotonin and noradrenaline, blocking the reuptake of these two neurotransmitters in the neuronal membrane.blocking the reuptake of these two neurotransmitters into the neuronal membrane. It is also an antagonist of histamine H1, alpha-1-adrenergic, serotoninergic 5-HT2 and muscarinic receptors. It is also a potential-dependent sodium channel blocker.

Administration

Dosulepin is taken orally, being marketed in 25mg and 75mg tablets. For depression it is usually prescribed between 75mg and 150mg per day, the maximum recommended dose for this diagnosis being 225mg per day.. In the case of pain treatment and prevention of migraines, the usual dose is about 75mg daily taken before going to bed, the maximum dose being 150mg.

This drug produces drowsiness, for this reason it is recommended to take it once a day, especially before going to sleep. In case you wake up the next day feeling drowsy, it is recommended to take the pill a little earlier than you did the night before.

Sometimes, at the beginning of the treatment, it is prescribed to take low doses two or three times a day until the body gets used to the drug. The aim of this is to avoid side effects dependent on overdosage.

Dosulepin can be taken with or without food, always with a glass of water.It is always taken with a glass of water and without chewing the tablet.

Side effects

As with all psychotropic drugs, dosulepine may have some side effects.These are due either to an overdose of the drug or to an allergic reaction to it. Most of these side effects eventually subside once the body has become accustomed to dosulepine.

Digestive effects

Dosulepin may cause some undesirable effects on the digestive tract, such as dry mouth, nausea, vomiting, diarrhea and constipation.. If constipation is prolonged over time, it may cause stomach pain.

Effects on the circulatory system

One of the most dangerous effects that this drug can produce is heart problems, especially arrhythmias and tachycardia.. In addition, hypertension may occur. In the most serious cases, myocardial infarctions and heart attacks may occur.

Skin effects

Blistering may occur, as well as hives, rashes and increased sensitivity to sunlight. and increased sensitivity to sunlight.

Liver problems

The liver may be damaged, leading to hepatitis.which may cause the skin and whites of the eyes to turn yellowish.

Because of poor liver regulation, blood glucose levels are altered.

Cognitive and psychiatric involvement

Dosulepine may cause drowsiness, dizziness, tiredness and general weakness.. Headaches may also occur.

In more severe cases there may be disorientation, lack of concentration, hallucinations, overexcitement, insomnia and nightmares. Anxiety and hypomania may occur.

Other effects

Some notable effects of different nature are impotence, gynecomastia, testicular swelling, tongue blackening, urination difficulties, weight loss and/or weight gain and increased eye pressure.

Contraindications and precautions

These are the populations and situations in which dosulepin is contraindicated.

Pregnancy and lactation

Dosulepin has been associated with a very low risk to the fetus. Even so, in case of suspicion of pregnancy, it is recommended to consult a professional to meditate to change antidepressants to make sure that the unborn baby develops without problems.

During breastfeeding, if no problems are noted in the newborn, dosulepine can continue to be taken, given that dosulepine reaches the breast milk in very small quantities..

Driving

Since this drug causes drowsiness, it is not recommended to drive or operate machinery, it is not recommended to drive or operate heavy machinery after taking dosulepin. after taking dosulepin.

Interactions with other substances

Dosulepin may interact with alcohol. In addition, like other tricyclics, this drug potentiates the effects of barbiturates, anxiolytics and central nervous system depressants. of the central nervous system.

Dosulepin has antihistaminic and anticholinergic effects, which, when combined with other drugs that also have these effects, increase them, and their joint prescription is contraindicated.

Está contraindicado el consumo de dosulepina y hierba de San Juan, un remedio natural para la depresión, dado que consumidos de forma conjunta incrementan el riesgo de sufrir efectos adversos.

Referencias bibliográficas:

• Adán, A. y Prat, G. (2016). Psicofarmacología: Mecanismo de acción, efecto y manejo terapéutico. Barcelona, España. Marge Medica Books.
• Lancaster S. G., Gonzalez J. P. (1989). Dothiepin. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy in depressive illness. Drugs. 38 (1): 123–47.
• Donovan S., Dearden L., Richardson L. (1994). The tolerability of dothiepin: a review of clinical studies between 1963 and 1990 in over 13,000 depressed patients. Prog. Neuropsychopharmacol. Biol. Psychiatry. 18 (7): 1143–62.
• Thanacoody H. K., Thomas S. H. (2005). Tricyclic antidepressant poisoning : cardiovascular toxicity. Toxicol Rev. 24 (3): 205–14.
• Feinmann, C; Harris, M.; Cawley, R. (1984). "Psychogenic facial pain: presentation and treatment". Br Med J (Clin Res Ed). 288 (6415): 436–8.
• Vademecum. (2016). Dosulepina.