Dosulepin (Prothiaden, Thaden)
Dosulepin is a tricyclic antidepressant. After 1998, it was also called dothiapin and was available under both generic names.
The Bottom Line: What You Really Need to Know
- Dosulepin is used to treat depression with an anxiety component. It is not available in the USA.
- The usual starting dose of dosulepin is 25 mg three times a day. The dose is gradually increased to a total daily dose of 225 mg or more.
- Dosulepin interacts with many different medications. Make sure you tell your physician and pharmacist about all medications that you take, including herbal remedies and teas, over the counter medications, homeopathic and alternative treatments, vitamins, supplements and medications you only take occasionally.
- If you have surgery, make sure your surgeon knows you take dosulepin. It can interact with anesthetics.
- It may take two weeks or more before you start feeling better.
- Talk to your doctor before you stop taking dosulepin. Your dose may need to be tapered down slowly to prevent uncomfortable withdrawal symptoms.
- Most people experience a few mild side effects, like dry mouth or constipation, when they begin taking dosulepin. They usually go away with time.
- If you have heart disease or heart rhythm problems, you should not take dosulepin.
- You should not take dosulepin if you have porphyria.
- If you experience loss of interest in sex or diminished sexual ability, talk to your doctor about it.
- Have a friend or family member check in with you every day for the first few weeks that you take dosulepin. Ask him or her to help you monitor your condition for:
- Worsening depression
- Restlessness, irritability, agitation, hostility or aggression
- Unusual thoughts or thoughts of suicide
- Report any serious or unusual side effects to your doctor.
Dosulepin is used to treat depression with an anxiety component. It has not been approved by the FDA and is not available in the US.
Dosage and instructions
The effective dose of dosulepin varies widely between individuals. Most people start by taking 25 mg three times a day. The dose is gradually increased to 50 mg three times a day. It can also be taken as a single dose at bedtime. Some people may need up to 225 mg/day of dosulepin.
Elderly people usually need a reduced dose. The usual daily dose for elderly people is 50-75 mg/day.
How dosulepin works
Dosulepin and other antidepressants work by regulating the balance of neurotransmitter chemicals in the juncture between nerve cells. Imbalances in these substances, especially in serotonin, norepinephrine and dopamine are thought to cause mood and anxiety disorders. Dosulepin improves depression and anxiety by regulating the neurotransmitters, especially serotonin, dopamine and norepinephrine. It also affects other neurotransmitters, particular cholinergic substances. Many of the side effects of dosulepin are related to its anticholinergic actions.
Many people experience mild, transient side effects when they first begin taking dosulepine. These can include dry mouth, metallic taste, constipation and large bowel movements and blurred vision.
Other side effects can include heart palpitations, difficulty urinating, tremors, low blood pressure (especially if you stand up suddenly), sexual problems, sweating, and sensitivity to sunlight.
Alcohol and other intoxicants and central nervous system depressants increase the effect of dosulepin.
Dangerous interactions can occur between dosulepin and other antidepressants, including MAOI and SSRI antidepressants. Symptoms can range from anxiety, restlessness and trembling to seizures, delusions and hallucinations, delirium, high fever, cardiovascular instability, and death.
Medications that regulate the heart beat can also interact with dosulepin.
Dosulepin can interact with anesthetics and should not be taken prior to elective surgeries.
The dose of dosulepin should be gradually tapered before you stop taking it. If you stop too quickly, you can experience dizziness, nausea, headache, chills, anxiety and other discontinuation symptoms.
Warnings, precautions and contraindications
- Don't take dosulepin if you have taken other antidepressants within the past two weeks.
- Don't take dosulepin if you have had a recent heart attack or if you have heart rhythm problems
- Dosulepin can trigger manic episodes and rapid cycling in people with bipolar disease.
- Dosulepin should be used with caution in people who have liver disease, thyroid problems, seizures, tumors of the adrenal glands, glaucoma, diabetes, high blood pressure or urinary problems.
- People who have porphyria should not take dosulepin.
- You should stop taking dosulepin several days before having surgery. Dosulepin can interact with anesthetics.
- Don't operate machinery or engage in dangerous activities until you see how dosulepin affects you.