List of side effects of doxepin explained

The antidepressant drug doxepin has been associated with a number of different adverse effects, including the following.^{[1] [2] [3]}

The incidence of these adverse effects is not totally known as the scarcity of well-designed clinical trials involving doxepin prohibits it. Side effects that are common (based on its pharmacology or the frequency of these side effects with related agents) appear with a * superscript whereas the serious side effects are in bold. Doxepin is licensed to be used in much smaller doses (viz., 3mg and 6 mg) in some countries, the side-effects profile of which may differ from this list.

• Nausea^*
• Dizziness^*
• Drowsiness^*
• Dry mouth^*
• Constipation^*
• Blurred vision^*
• Headache^*
• Urinary hesitancy^*
• Agitation^*
• Hypotension (low blood pressure)
• Hypertension (high blood pressure)
• Tachycardia (high heart rate)
• Skin rash
• Facial oedema
• Photosensitisation
• Urticaria (hives)
• Pruritus (itching)
• Indigestion
• Bone fractures
• Taste disturbances
• Diarrhoea
• Anorexia (weight loss)
• Aphthous stomatitis (canker sores)
• Gynaecomastia (swelling of the breasts in men)
• Galactorrhoea (lactation that is unassociated with breast feeding or pregnancy)
• Chills
• Fatigue
• Weakness
• Flushing
• Alopecia (hair loss)
• Eosinohpilia
• Blood dyscrasias (abnormalities in the cellular composition of blood)
• Increased liver function tests
• Hyperpyrexia (high fever ≥41.5 °C or 106.7 °F)
• Seizures
• Confusion
• Malaise
• Increased appetite^*
• Changes in ECG parameters (e.g. QRS & PR interval)
• Ataxia
• Hallucinations
• Paraesthesias
• Nervousness
• Numbness
• Tinnitus
• Hepatitis (liver swelling)
• Exacerbation of asthma
• Hepatic (liver) abnormalities
• Urinary retention
• Extrapyramidal symptoms
• Testicular swelling
• Hyperglycaemia (high blood sugar)
• Hypoglycaemia (low blood sugar)
• Hyponatraemia (low blood sodium)
• Syndrome of inappropriate secretion of antidiuretic hormone (SIADH)
• Closed-angle glaucoma
• Alzheimer's disease or dementia* ^[4]

Notes and References

1. Web site: Sinepin Capsules 25mg - Summary of Product Characteristics (SPC). electronic Medicines Compendium. Marlborough Pharmaceuticals Ltd. 22 September 2011. 3 December 2013.
2. Web site: Deptran Doxepin (as hydrochloride). TGA eBusiness Services. Alphapharm Pty Ltd. 6 May 2013. 3 December 2013. PDF.
3. Web site: Silenor (doxepin) dosing, indications, interactions, adverse effects, and more. Medscape Reference. WebMD. 3 December 2013.
4. Gray. Shelly L.. Anderson. Melissa L.. January 26, 2015. Cumulative Use of Strong Anticholinergics and Incident Dementia: A Prospective Cohort Study. JAMA Intern. Med.. 10.1001/jamainternmed.2014.7663. January 27, 2015. 25621434. 4358759. 175. 3 . 401–7.