Comparative Pharmacology
Head-to-head clinical analysis: DOXEPIN HYDROCHLORIDE versus SURMONTIL.
Peer-Reviewed Evidence
Head-to-head clinical analysis: DOXEPIN HYDROCHLORIDE versus SURMONTIL.
DOXEPIN HYDROCHLORIDE vs SURMONTIL
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.
Tricyclic antidepressant that inhibits the reuptake of norepinephrine and serotonin, with anticholinergic, antihistaminergic, and alpha-adrenergic blocking properties.
25-150 mg orally at bedtime; initially 25 mg, may increase gradually to 150 mg. For minor depression: 25-50 mg orally at bedtime.
50-75 mg/day orally in divided doses, increase gradually to 150-300 mg/day. Maximum 300 mg/day. Single bedtime dose may be used for maintenance (50-150 mg).
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.
11-27 hours (mean approximately 20 hours) for the parent drug; the active metabolite desmethyltrimipramine has a half-life of 15-30 hours. Steady-state is achieved within 5-7 days.
Primarily renal (50-60% as metabolites, <5% unchanged). Biliary/fecal: approximately 20-30%.
Renal excretion of metabolites accounts for approximately 70-80% of elimination, with about 20-30% excreted in feces via biliary elimination. Unchanged drug in urine is less than 5%.
Category C
Category C
Tricyclic Antidepressant
Tricyclic Antidepressant