dosulepin hydrochloride at a glance
Medicine class
Tricyclic antidepressant
Licensed role
Symptoms of depressive illness, especially when an anti-anxiety effect is required
Starting treatment
Restricted to specialist care for people not previously taking dosulepin
Important safety point
Highly toxic in overdose; store securely away from children and other people
What is dosulepin hydrochloride used for?
Licensed for depressive illness, with use restricted by substantial overdose and cardiac risks.
Treatment of symptoms of depressive illness, especially when an anti-anxiety effect is required.
Use when suitable alternatives have not worked or cannot be tolerated; initiation in a new patient is restricted to specialist care.
How does dosulepin hydrochloride work?
Dosulepin reduces reuptake of noradrenaline and serotonin at nerve endings, increasing their activity in the brain; it also affects dopamine. Its antimuscarinic and antihistamine actions help explain dry mouth, constipation, blurred vision and drowsiness.
dosulepin hydrochloride preparations and strengths
Capsule
Route: Oral
Strengths: 25 mg
Tablet
Route: Oral
Strengths: 75 mg
How to take dosulepin hydrochloride
Follow the individual directions from the prescriber and discuss any changes or stopping treatment with them.
Swallow tablets and capsules whole with water; do not chew them.
Do not drive or operate machinery until you know how it affects you.
Avoid alcohol because it can worsen drowsiness and other central nervous system effects.
Store it securely and out of children’s sight and reach.
dosulepin hydrochloride side effects
Common or expected effects
- Dry mouth
- Blurred vision or difficulty focusing
- Constipation or difficulty passing urine
- Drowsiness
- Sweating
- Tremor
- Dizziness on standing or faintness
- Fast heartbeat or altered heart conduction
- Changes in appetite or weight
- Sexual difficulties
Get urgent medical advice
- Fast or irregular heartbeat, collapse or severe dizziness
- Seizure
- Signs of liver injury, such as yellow skin or eyes or dark urine
- Marked confusion, extreme excitability, mania or psychotic symptoms
- Severe allergic reaction
- Unusual infections, fever, bruising or bleeding
- Severe drowsiness, confusion or convulsions
- New or worsening thoughts of self-harm
dosulepin hydrochloride in pregnancy
Avoid during pregnancy unless there are compelling reasons because medicine-specific evidence is limited. Tricyclic antidepressants as a group are not known to harm the baby, although use near delivery can cause temporary newborn withdrawal or adaptation symptoms. Review treatment with the prescriber rather than stopping suddenly.
dosulepin hydrochloride while breastfeeding
Dosulepin passes into breast milk, but levels are considered unlikely to cause problems. Evidence is limited and other tricyclic antidepressants are preferred. Seek specialist assessment, particularly for a premature or unwell infant, and watch for unusual sleepiness, poor feeding, inadequate weight gain, constipation or fewer wet nappies.
dosulepin hydrochloride interactions
Dosulepin has important interactions affecting heart rhythm, alertness, blood pressure, seizure risk and medicine concentrations. Check all prescribed, pharmacy and recreational substances.
Monoamine oxidase inhibitors
Must not be used concurrently; switching requires prescriber-led planning.
Selective serotonin reuptake inhibitors
Concurrent use should generally be avoided because some can increase dosulepin concentrations and toxicity.
Common questions about dosulepin hydrochloride
Answers are fully visible for fast scanning and source review.
Why is dosulepin hydrochloride not routinely started in the UK?
It has substantial cardiac toxicity and can be rapidly fatal in overdose. New treatment is restricted to specialist care when suitable alternatives cannot be used or have not worked.
Can dosulepin hydrochloride make me sleepy?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.