dosulepin

N06AA16

Forms & Strengths

Adult Dosing

Depression: Initial 75 mg/day in divided doses or as a single bedtime dose, titrated gradually up to 150 mg/day
Maximum outpatient dose: 150 mg/day
Hospitalized patients: Up to 225-300 mg/day in severe cases

Pediatric Dosing

Not recommended for use in children and adolescents under 18 years of age due to lack of efficacy data and increased risk of suicidal behavior and ideation

Indications

Mechanism of Action

Tricyclic antidepressant (TCA) that inhibits the neuronal reuptake of norepinephrine and serotonin in the central nervous system, thereby increasing their synaptic concentrations

Contraindications

Hypersensitivity to dosulepin or other dibenzoxepin tricyclic antidepressants
Recent myocardial infarction
Any degree of heart block or cardiac arrhythmias
Severe hepatic impairment
Concurrent treatment with monoamine oxidase inhibitors (MAOIs) or within 14 days of discontinuation
Mania

Adverse Reactions

Anticholinergic effects: dry mouth, blurred vision, constipation, urinary retention
Central nervous system: drowsiness, dizziness, tremor, confusion
Cardiovascular: orthostatic hypotension, tachycardia, ECG changes, QT prolongation
Metabolic and endocrine: weight gain, sexual dysfunction
Hematological: rare agranulocytosis, leukopenia

Drug Interactions

MAOIs: risk of severe serotonin syndrome, hypertensive crisis, and hyperpyrexia
CNS depressants (alcohol, barbiturates, benzodiazepines): enhanced sedation and respiratory depression
Sympathomimetic amines: potentiated cardiovascular effects leading to severe hypertension or arrhythmias
CYP2D6 inhibitors (e.g., fluoxetine, paroxetine): increased plasma concentrations of dosulepin and heightened toxicity risk
Anticholinergic drugs: additive anticholinergic adverse effects

Curated Content: Needs Vetting Before Put to Clinical Use