Comparative Pharmacology
Head-to-head clinical analysis: DOXEPIN HYDROCHLORIDE versus ENDEP.
Peer-Reviewed Evidence
Head-to-head clinical analysis: DOXEPIN HYDROCHLORIDE versus ENDEP.
DOXEPIN HYDROCHLORIDE vs ENDEP
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Doxepin is a tricyclic antidepressant (TCA) that inhibits the reuptake of serotonin and norepinephrine, thereby increasing their concentrations in the synaptic cleft. It also exhibits potent histamine H1 receptor antagonism, leading to antihistaminic effects, and has anticholinergic, alpha-adrenergic blocking, and anti-serotonergic properties.
Increases synaptic concentrations of serotonin and norepinephrine by inhibiting their reuptake in the central nervous system.
25-150 mg orally at bedtime; initially 25 mg, may increase gradually to 150 mg. For minor depression: 25-50 mg orally at bedtime.
Initial 75 mg/day orally in divided doses, increased gradually to 150-200 mg/day; maintenance 50-150 mg/day as single dose at bedtime or in divided doses.
None Documented
None Documented
Terminal elimination half-life: 8-24 hours (mean 15 hours). Steady-state achieved in 3-5 days. Active metabolite nordoxepin has half-life of 31-50 hours.
Terminal elimination half-life: 15-40 hours (mean ~24 h); clinical context: steady-state achieved in 5-7 days; prolonged in elderly and CYP2D6 poor metabolizers.
Primarily renal (50-60% as metabolites, <5% unchanged). Biliary/fecal: approximately 20-30%.
Renal: 70-80% as metabolites (including glucuronides, unchanged drug <5%); Biliary/Fecal: 20-30%.
Category C
Category C
Tricyclic Antidepressant
Tricyclic Antidepressant