dothiepin

[hpchong7]

Dear sir,
   One year ago I had depression problem and take dothiepin (HCL capsule 25MG, 1 capsule per day) for nearly 3 months and then recovered.
   However, due to life pressure and numerous reason my depression occured again so I took the dothiepin again, same amount and frequency as last time.But this time I did not feel any difference before and after taking the drug.So, should I double my amount?Is it I have a resistance to this drug?

[Roger Gould, M.D.]

I do not recognize this medication.  Do you mean Doxepin? If so, that should be given under strict supervision, and requires frequent laboratory tests. YOu might ask your doctor about the newer ssri antidepressants that have few side effects and are quite effective.

[CCB]

Dothiepin, like doxepin, is a tricyclic antidepressant.  For patients that have insomnia or anxiety, it may be especially helpful.  It takes a few weeks to notice a drug response (how long have you been taking it?) and Do you smoke or take anything else for anxiety? (Smoking, use of barbiturates, or antihypertensive medications sometimes perscribed for anxiety-propranolol, atenolol-may disrupt its effectiveness).  Are you in the U.S. I dont think this drug is regulated by the FDA?

[hpchong7]

THanks for your response.This time I have just taken the medicine for a few days consecutively,each day 1 capsule.Really no effect at all.I remember when the 1st time I have depression, I just took 1 capsule and then I will sleep for around 15 hours the next day, very very effective, and at that time I just take 1 capsule for every 2 or 3 days.So how should I do now?Thanks!

ps:I live in Hong Kong.My depression is caused by personality disorder.

[CCB]

hpchong7,
The reason that the doctor didnt recognize the drug is that dothiepin is not a U.S. FDA regulated drug, so the forum doctor may not be able to give you any information about a dosage increase.  Do you also have anxiety? what has your doctor said about a dosage increase or switching medications (to maybe an SSRI)?

[lupercal]

Hi. I'm in Australia, and am taking dothiepin (brand name Prothiaden here). 25 mg is a very low dose and would almost certainly be considered sub-therapeutic for depression (though it may help for sleep problems). The usual starting dose is 75 mg, and I've read one doctor's comment that even that is a sub-therapeutic dose. Don't increase your dosage without consulting your doctor, but ask him/her about increasing it.