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Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

Doxepin discontinued

Doxepin (Sinequan)® capsules are being discontinued in all strengths according to the National Electronic Library for Medicines.

Doxepin is a tricyclic antidepressant with sedative properties. It is expected that supplies will be exhausted by October 2006 although some strengths may disappear sooner.

Doxepin is not widely used but is not available generically and therefore alternative products will need to be used if treatment needs to continue. Amitryptiline, Dosulepin or Clomipramine may be suitable choices.

Action: Clinicians should be aware of this products discontinuation and may wish to identify individuals currently taking this drug. Alternative treatments will need to be investigated if treatment will continue beyond October 2006.

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35 Comments to “Doxepin discontinued”

  1. I have been on doxepin for 30 years. I had bad reaction to amitriptyline. It brings on anxiety and a bad ringing in my brain. I then have to taken lorezepam and a sleeping tablet while going through struggles with sleep.
    I have just started to switch to a different brand of doxepin from ratiopharm. First night I took 3 of my normal anten doxepin 25mg and 1/4 tablet of the new doxepin.
    I was told it was the same. Within 30 minutes I had developed a bad ringing in my brain and had to taken lorazepam and sleeping tablet to sleep while feeling crazy! So many people are suffering. Can we lobby to bring back anten doxepin.
    Or how do you wean off that stuff? I'm in New Zealand.

    Comment by Nicki Bell — January 8, 2021 #

    1. @Nicki,

      It seems that the manufacturer of Anten (Mylan) notified the New Zealand authorities in early 2019 that it was being discontinued. If you have generic dose-in it contains the same active ingredient but other ingredients may vary. It's strange that you have such a pronounced reaction but worth bringing it to the attention of your doctor to see if they can think of an alternative for you to try.

      Comment by Matthew Robinson — January 11, 2021 #

      1. My doctor wants me to try citalopram SSRI. Have people had success switching from an ssri from doxepin? I'm still not sleeping at night and have been off doxepin for 3 weeks now. I'm taking zopicone to sleep which is not ideal.

        Comment by Nicki Bell — March 7, 2021 #

        1. @Nicki Bell,

          There are certainly people who have switch from drug like doxepin to SSRIs, there are recommendations on how to do this here in Britain based on past experience in places like mental health hospitals and trusts. How successful it is will probably depend on why you are not sleeping at night, but sleep hygiene measures (so a good mental approach to sleep) will also be of help over time.

          Comment by Matthew Robinson — March 7, 2021 #

          1. I am 65 and have had insomnia since I was 19 years old. I live in the US. All drs have done is prescribed sleeping pill and I don't mean antidepressants. Sounds like UK doctors are smarter and care about their patients. Now that I'm 65 they want to stop any meds for sleep. So now I stay awake and its gonna cause my death sooner than later. I cannot function from lack of sleep. I can't take care of myself and its causing alot of my health problems. Doxepin is still prescribed here. I was given a script even though I tried it years ago and it caused me to climb walls told doctor and he didn't seem to care. Any advice? I go so long without sleep I hallucinate and almost died from it, I ended up in hospital woke up and didn't remember how or why I was in there.

            Comment by Sherri Gilson — April 16, 2021 #

          2. Sherri,
            I wish you the best with that medication. I just started the capsules at 10 mg. It's for insomnia as well. I am a bit let down. I have been without sleep so long, I am grumpy, snappy. I expected it to knock me off my feet the first night and I take it with 50 mg hydroxyzine. Took the medications at 10 pm, felt tired about 11:20 pm. Got about 4 hrs of sleep and I was awake from 2:43 am till 8:00 am. I am trying to function today but I am very dizzy. Not the norm for me. My daughter asked about the medication and raised blood pressure. Sure enough it was high and after looking it up that is a side effect. I have never had high blood pressure my whole life. The biggest problem for people our age is they cannot give us anything that works because its high risk from age 65 and up. I had insomnia in my thirties and they gave me clonazepam. It really worked, I did not have to take it every night. A year later things in my life got better and I didn't need it anymore. So I requested clonazepam from my now Doctor and he refused because its addictive. I explained I was not addicted before some thirty years ago. I stopped taking it myself. I was told at my age NOW the risk is higher to get addicted. They were concerned about next day lay over - drowsiness or falling. I was so dizzy from it boosting my blood pressure today, I almost passed out. I have been in bed the most of the day. So I guess it's back to the drawing board. I certainly pray you can get some sleep. We have to deal with so much going on around us, getting sleep will help us cope better.

            Comment by Mae Reid — April 18, 2021 #

          3. It obviously hasn't affected your capacity to commit to detailed descriptions. It could be surmised you're happier when engaging in challenging efforts as displayed with your self descriptions.
            Other ideas away from pharma are available with a return to this post.

            Comment by Jack Hammer — May 24, 2021 #

          4. So sorry to hear that. I'm addicted to doxepin and klonopin (clonazepam) because I'be been taking them for so long. Doxepin causes my heart to race so it keeps me up at night. I'm going to try a more natural approach since I've had so many bad reactions to every pill. I am 65 and didn't want to die from abnormal heart beat. Don't want another addictive drug to sleep. Try therapy, meditation, vitamins and herbs to sleep.

            Comment by Hannah — May 31, 2021 #

        2. I've taken doxepin for 30 years, it now causes my heart to race at 65 and keeps me awake instead. Stay off this drug! It can also cause dementia. I'm getting off it and deal with problem another way. It's not worth dying of a heart attack over. Take vitamins and herbs, it never helped my depression anyway. Just drugged me up and now I lie awake with fast heart rate all night!

          Comment by Hannah — May 31, 2021 #

  2. I posted in July - still on a roller coaster to find an alternative in NZ - so far nortriptyline, mirtazapine, buspirone, clonazepam and then diazepam taken with the mirtazapine. Just recovering after beginning quetiapine and sertraline - massive fail. Am going back to low doses of clonazepam and mirtazapine - less than ideal but the best of the fails. Doctorr also said I could take phenergan for sleep - not sure if that should be with or instead of the other sedative meds? He suggested phenergan instead of quetiapine but I have lost faith and will not take the sertraline either. Life is not good right now. Strangely I had taken diazepam on its own for many years when younger - perhaps it doesn't like being combined with mirtazapine?

    Comment by Sheryl Day — December 21, 2020 #

    1. @Sheryl,

      It seems that here in the UK since I posted this original artifice that several other manufacturers have stepped in and started producing doxepin - that said they seem to be taking financial advantage of the situation by currently pricing 28 packs of the 25mg at £97 and 28 of the 50mg at £154 (Prices from Drug Tariff for Dec 2020).

      One option that you seem not to have tried, a drug that is quite similar to doxepin is dosulepin (or dothiepin). You may want to ask your doctor about it and check if it is possible for you.

      Comment by Matthew Robinson — December 21, 2020 #

    2. Phenergan will make you sleepy at right dose, probably help better than that antidepressant. It's not a good drug for sleep in my experience but I've been on just about everything for insomnia - I've had it since I was 19 and I'm 65.

      Comment by Sherri Gilson — April 16, 2021 #

    3. For gosh sakes, I'm trying to get off doxepin after years of it and klonopin (clonazepam). It causes me bad heart rate issues. I've taken some of that stuff. I'm trying to get off all this rubbish. Mirtazapine put me under a train. Tired of being doped up at 65. I just took doxepin and my heart rate is up.I slept before I was on this drug. I'll find something else. We're addicted to this mess. Take vitamins and herbs, do meditation, take exercise, anything. Doctors want patients for life even if it means taking their life. I'd rather anything than a bad heart. Look up side effects of these medicines.

      Comment by Hannah — May 31, 2021 #

  3. I have been on doxepin 30 years, prior to that diazepam, stopped suddenly, no weaning as suddenly doxepin unavailable after years of threatening to become so. Nortriptyline caused side effects partly I feel as I came off Doxepin cold turkey while beginning the nortriptyline. Next was mirtazapine, went deaf and massive sinus headache, Doctor gave meds for sinus which I didn't take but stopped the new pill and hearing came back slowly. Weaned myself off that and now on nothing but clonazepam as needed while await specialist pyschiatrist appointment. (just for someone with knowledge of meds - I hope!!) Not doing so well. Have some buspirone that I was prescribed but didn't ever use - am thinking will self medicate with this - can't be any worse surely that the meds I have not adjusted to? Wondering why amitriptyline has not been prescribed - other family members seem to tolerate that. Am fed up and life looking very dismal.

    Comment by Sheryl Day — July 4, 2020 #

    1. @Sheryl Day,

      Amitriptyline may be an option worth trying for you but then again it is very similar to nortriptyline in terms of side effect profile. I hope you manage to find something that suits you are works well for you.

      Comment by Matthew Robinson — July 4, 2020 #

      1. Still looking - not doing so well - desperate and began the buspirone. Very small dose but after 4 days suddenly pulse rate down to 52 and thumping - scary so stopped this drug too! Still waiting for mental health evaluation / advice. Light headed nauseous, tired, waking early, sometimes not getting to sleep and weight loss. Anyone had a successful alternative to doxepin - I stopped it in May and am still withdrawing??

        Comment by Sheryl Day — July 23, 2020 #

        1. Like you, I was on Deptran for about 30 years at 25mg. I went to the pharmacy to get a refill the other night and was told it was discontinued. Back to my doctor next day, and I was told to take nothing for 2 days then go onto Endep 10 (Amitriptyline). It's only been 2 nights, but I'm sleeping well and feel happy, and my chronic pain is already zapped by about 50%. Maybe it's all in my mind, as it seems so fast, or perhaps I didn't completely withdraw from Doxepin. Try it.

          Comment by Kezza — September 12, 2020 #

        2. Where do you live? I am in California. Doxepin is not being discontinued here. I have been using it since the 1970s.

          Comment by Patrice Nagel — December 18, 2020 #

        3. Seems like alot of doctors need to read up on sleep deprivation. You actually can die from it. There are plenty of sleeping pills out there.

          Comment by Sherri Gilson — April 16, 2021 #

          1. Yes there are but you shouldn’t take them. I am 65 and was started on doxepin at 33. I now have heart palpitations with doxepin and everything else gave me severe side effects. I'm addicted. It's hell trying to get off but I’m not going to die from tricyclics.

            Comment by Hannah — May 31, 2021 #

    2. This medicine is being carried by KnippeRx Pharmacy in America
      855 647 7379

      Comment by Felice Evans — November 1, 2020 #

    3. Amitriptyline (Elavil®) will take all of your withdrawal symptoms away and work better than Sinequan. You'll need the same milligram dose.

      Comment by Larry Kirkman — December 3, 2020 #

    4. I've been on doxepin and (clonazepam) klonopin for years. Doxepin is affecting my heart now so I'll have to stop it. I've tried all antidepressants and had severe side effects! Even tried me on antipsychotics. I slept fine before being put on this mess years ago and you take it at bedtime so you're addicted. Read side effects of these drugs! Get a good doctor if you can find one. Exercise, take vitamins and herbal tea, anything. I've been putting poison in my body and I'm tired of it. Don't know what I'll do but it's got to be better!

      Comment by Hannah — May 31, 2021 #

  4. I just went yesterday to get my monthly script filled out and was shocked to find it is no longer funded. My doctor here in NZ never mentioned anything too me, so unprofessional, and I have been on a sickness benefit because I'm bipolar so I didn't have the money to pay for the medication. Because I can't not take it I had to go borrow the money just so I could have the months worth of medication, I am so angry and now really panicked and upset. I have been on every antidepressant you can think of, 6 years ago I was put on doxepin and because I suffer from insomnia too and it helped me sleep. Finally, I found a medication that worked for me, my depression has been a lot better since I have been on doxepin, but every time I have had to change antidepressant medication I have been at my most vulnerable mentally. On some medications my depression has been so bad I have self harmed and had extreme suicide tendencies, so to be told without any notice that this medication is no longer funded and I can't afford to take it and I have to find something else is a huge thing. I'm terrified of the repercussion of coming off this medication, one that finally works for me and to have to change onto something that could have the worst effects on me. I sent a letter to pharmac telling them these decisions to stop funding a antidepressant like this is not only reckless but dangerous to those on it. My anxiety is through the roof and I'm so disappointed and upset that a decision to stop funding this medication has such a negative affect on someones life. By what Warren Higham said I'm sick with worry and concern I won't find a good alternative either.

    Comment by Danny Smitten — June 13, 2020 #

  5. The NHS stopped prescribing Trimipramine and Doxepin amongst others because two brothers got around a generic drug loophole. Drugs like trimipramine for 28x50mg tablets used to cost £7.80 they now cost £200.50. Doxepin for 28x50mg £154.00. NHS wants patients off these drugs because there are cheaper alternatives. But having tried numerous tricyclics I can vouch that they are not that similar to each other.

    Comment by Stephen Mathieson — May 6, 2020 #

  6. If this medication is being discontinued and expected to run out by 2006 how come I've been on it for 4 years?

    Comment by Gordon Stuart Montgomery — November 7, 2019 #

    1. @Gordon Stuart Montgomery,

      At the time of the original post there were no generic options available. It seems that some stepped in and started making doxepin when the branded version (Sinequan®) was discontinued.

      Comment by Matthew Robinson — November 7, 2019 #

    2. I was thinking the same thing. I've been on Doxepin 75mg×2 since the 1970s. This is the only Antidepressent that works for me. I have a hard time sleeping and the Doxipen helps. Are you in the US? I'm asking because it looks like it's being taken off the shelf in NZ. If it's going to be discontinued I need to find an Online Pharmacy so I can stock up.

      Comment by Patrice Nagel — December 18, 2020 #

  7. Why has doxepin recently been discontinued in New Zealand? No reason has been given on the internet.

    Comment by Colin Rammell — October 15, 2019 #

    1. @Colin Rammell,

      We don't use dose-in very much here in the UK, but an internet search I did found this:


      Following some of the links suggests it was discontinued due to main ingredient shortages.

      Comment by Matthew Robinson — October 16, 2019 #

  8. I have been taking doxepin for almost 26 years, I am worried about switching to another medication besides doxepin because this is good medicine to control my anxiety and panic attacks. My question is which medication you would recommend to take instead doxepin when I finish my last month supply..thanks

    Comment by Jesus Salabarrieta — August 7, 2019 #

    1. @Jesus Salabarrieta,

      There are a few options but your own doctor is best placed to advice as they have access to your medical history and can ensure the alternative is suitable for you.

      Comment by Matthew Robinson — August 7, 2019 #

    2. I've also been on Doxepin for 26 years and have come off it slowly. I'm now on to my second lot of replacement antidepressants and have gone through hell so far. Not suitable and a lot of GI side effects. My doctor says that my body will get used to it. Sorry, not going to happen as I've been on my current one for 2 months and there is no let up with the GI side effects and I feel very flat in mood, I've lost my spark that I had on Doxepin. There must be a closer alternative surely.

      Comment by Warren Higham — January 15, 2020 #

      1. @Warren Higham,

        Doxepin is classified as a tricyclic antidepressant, there are several alternatives available in the UK. Amitriptyline, nortriptyline, imipramine and clomipramine are some examples you could perhaps ask your doctor about.

        Comment by Matthew Robinson — January 15, 2020 #

    3. Doxepin has helped mr but did not help my mood. It is causing me to have a fast heart rate. I am 65 and will have to stop this awful drug. I've been on it for 30 years but slept fine with just (clonazepam) klonopin at night. I slept fine before klonopin. I want off these bad drugs. Dementia is known to be a possible long term side effect and the same is true for benzodiazepines so you better get help from something else. Don't know what I will do but it's hell trying to get off them but it might save your life.

      Comment by Hannah — May 31, 2021 #

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