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Dothiepin (dosulepin)
How does it work?
This medicine contains the active ingredient dothiepin (also known as dosulepin) hydrochloride, which belongs to a group of medicines known as tricyclic antidepressants (TCA). When depression occurs, there may be a decreased amount of the chemicals noradrenaline and serotonin released from nerve cells in the brain. When these chemicals are released from nerve cells they act to lighten mood. When they are reabsorbed into the nerve cells, they no longer have an effect on mood. Dothiepin works by preventing this re-absorption of noradrenaline and serotonin back into the nerve cells. Therefore, it helps prolong the mood-lightening effect of any released noradrenaline and serotonin. This helps relieve depression. Dothiepin also blocks receptors in other areas of the body resulting in side-effects such as drowsiness. Therefore, dothiepin may be particularly useful in the treatment of depression where sedation or anxiety relieving therapy is required. The full benefits of treatment with dothiepin may not appear for two to four weeks.
What is it used for?
· Depression
Warning!
· Do not drink alcohol whilst taking this medicine.
· This medicine may reduce your ability to drive or operate machinery safely. Do not drive or operate machinery until you know how this medicine affects you and you are sure it won't affect your performance.
· This medicine may cause low blood sodium levels (hyponatraemia), which can result in drowsiness, confusion, muscle twitching or convulsions. Consult your doctor if you develop any of these symptoms while taking this medicine.
· Treatment with this medicine should not be stopped suddenly, but withdrawn gradually according to directions from your doctor. Abrupt withdrawal may cause symptoms such as nausea, vomiting, loss of appetite, headache, giddiness, chills, insomnia or anxiety.
Use with caution in
· Closed angle glaucoma
· Difficulty in passing urine (urinary retention)
· Disease involving the heart and blood vessels
· Elderly people
· History of epilepsy
· Hyperthyroidism
· Severe kidney disease
Not to be used in
· Children
· Defect of the heart's electrical message pathways resulting in decreased function of the heart (heart block)
· Irregular heart beats (arrhythmias)
· Mania
· People who have recently had a heart attack
· Severe liver disease
This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.
Pregnancy and Breastfeeding
Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.
· The safety of this medicine during pregnancy has not been established. The manufacturer therefore advises that it should be avoided during pregnancy. Seek medical advice from your doctor.
· This medicine may pass into breast milk, but in such small quantities that it is unlikely to harm the baby. Discuss with your doctor.
Label warnings
· This medication may cause drowsiness. If affected do not drive or operate machinery. Avoid alcoholic drink. | 
