Dothiepin (Dosulepin) Overview
Dothiepin, also called dosulepin, is a tricyclic antidepressant that’s been used for decades to lift mood and ease anxiety. It works by boosting the levels of serotonin and norepinephrine, two brain chemicals that help you feel more balanced. Doctors usually prescribe it for major depressive disorder, but it can also help with chronic pain, panic attacks, and insomnia when other pills don’t cut it.
Because dothiepin is older than many newer antidepressants, you’ll hear mixed opinions about it. Some people swear by its strong effect, while others worry about side effects. The key is to understand how to take it right, know what to expect, and keep an eye on any red flags.
How to Take Dothiepin Safely
Start low and go slow. Most doctors begin with 25 mg at bedtime, then increase by 25 mg every few days until you hit the lowest dose that works—usually between 50 mg and 150 mg per day. Taking it at night helps avoid daytime drowsiness, a common effect of tricyclics.
Swallow the tablet whole with a full glass of water. Don’t crush or chew it; the coating protects the drug and helps it dissolve gradually. If you miss a dose, take it as soon as you remember, unless it’s almost time for the next one—then just skip the missed tablet. Never double up.
Store dothiepin at room temperature, away from moisture and heat. Keep it out of reach of children and pets. If you travel, pack it in your carry‑on to avoid temperature swings in checked luggage.
What to Watch Out For: Side Effects & Interactions
Common side effects include dry mouth, constipation, blurred vision, and a slight drop in blood pressure when you stand up. These usually ease after a week or two. If you feel dizzy, light‑headed, or notice a rapid heartbeat, call your doctor—those could signal a more serious reaction.
Serious but rare issues are heart rhythm problems and severe low blood pressure. If you have a history of heart disease, your doctor may run an ECG before starting dothiepin. Never mix it with other antidepressants, especially SSRIs or MAO inhibitors, unless your doctor says it’s safe. This combo can trigger serotonin syndrome, which feels like a fever, muscle stiffness, and confusion.
Alcohol can make dothiepin’s sedating effects worse, so limit drinking. Over‑the‑counter antihistamines, cold meds, and some pain relievers (like ibuprofen) can also add to drowsiness or raise blood pressure. Always check the label or ask a pharmacist if you’re unsure.
If you’re pregnant, planning to become pregnant, or breastfeeding, talk to your doctor. Dothiepin can cross the placenta and appear in breast milk, and the risks versus benefits need a careful look.
Finally, never stop dothiepin abruptly. Cutting it off can cause withdrawal symptoms like anxiety, nausea, and electric‑shock sensations in the brain. Taper slowly under medical supervision—usually dropping the dose by 25 mg every one to two weeks.
Bottom line: dothiepin can be a powerful tool for depression when used right. Start low, follow your doctor’s dosing plan, watch for side effects, and avoid risky drug combos. With the right care, many people find relief that lasts.