Experiences with
Dosulepin

Dosulepin is an antidepressant medicine that is used to treat depression.

Occasionally, dosulepin is also used for some types of nerve pain, such as fibromyalgia, and to prevent migraines.

Dosulepin is available on prescription, but usually only if you're already taking it and have not had any serious side effects.

It comes as capsules and tablets.

Who can take dosulepin

Dosulepin is usually only prescribed if you're already taking it and have not had any serious side effects.

If you have not had dosulepin before, your doctor will not usually prescribe it. This is because of the risk of serious side effects. Occasionally, however, it may still be the best choice of treatment for you.

If other treatments have not helped you, your doctor may refer you to a specialist (such as a psychiatrist or pain consultant). If the specialist thinks dosulepin is the best medicine for you, they may prescribe it.

Most adults aged 18 years and over can take dosulepin.

If you have diabetes, dosulepin can make it more difficult to keep your blood sugar stable. Your doctor may recommend that you monitor your blood sugar more often for the first few weeks of taking it. This is so they can adjust your diabetes treatment if necessary.

Who may not be able to take dosulepin

Dosulepin is not suitable for some people. To make sure it's safe for you, check with your doctor if you:

have ever had an allergic reaction to dosulepin or any other medicine
have a heart problem – dosulepin can make some heart problems worse
have a rare condition called porphyria
have liver or kidney problems
have epilepsy or are having electroconvulsive treatment – dosulepin may increase your risk of having a fit or seizure (jerking or shaking uncontrollably)
have an eye problem called glaucoma – dosulepin can increase the pressure in your eye
have thoughts about harming yourself or ending your life
are trying to become pregnant, are already pregnant or are breastfeeding
are going to be put to sleep (have an anaesthetic) before an operation

Dosage and strength

Dosulepin comes in 2 different strengths – either 25mg capsules or 75mg tablets.

The usual dose is:

depression – 75mg to 150mg a day. Your dose may gradually go up to 225mg a day if your specialist recommends it. The maximum dose for depression is 225mg a day
pain relief or preventing migraines – 75mg a day taken in the evening. Your dose may start at 25mg a day and gradually go up to 75mg a day. The maximum dose for pain or migraine is 150mg a day

How to take it

You'll usually take dosulepin once a day before bedtime. This is because it can make you feel sleepy.

If you're still feeling drowsy the next day, try taking it earlier in the evening.

Sometimes, if you're just starting treatment, your doctor may tell you to take a lower dose, 2 or 3 times a day until you get used to the medicine. This will reduce the chance of side effects.

Dosulepin does not usually upset your stomach, so you can take it with or without food.

Swallow the tablet or capsule whole with a drink of water. It will taste bitter, so do not chew it.

How long to take it for

For depression

Once you're feeling better, it's likely that you'll continue to take dosulepin for several more months.

Most doctors recommend that you take antidepressants for 6 to 12 months after you have stopped feeling depressed. Stopping before then can make your depression come back.

But dosulepin is no longer recommended instead of other antidepressants, so talk to your doctor about the risks and benefits of taking it. They may suggest taking another antidepressant.

Whether you change to another antidepressant or stay on dosulepin will depend on:

how severe your symptoms are
how often your symptoms happen
how well dosulepin works for you
whether you have had any severe side effects

For pain or preventing migraines

Some people take dosulepin for many months, or even for years. But dosulepin is no longer recommended instead of other antidepressants used to treat pain, such as amitriptyline.

Talk to your doctor about staying on dosulepin or switching to another medicine to treat or prevent pain.

If you forget to take it

If you take dosulepin once a day and forget a dose, take your next dose the next day at the usual time.

If you take dosulepin 2 or 3 times a day and forget a dose, take it as soon as you remember, unless it's nearly time for your next dose. In this case, skip the missed dose and take the next one at the usual time.

Never take 2 doses at the same time to make up for a forgotten one.

If you often forget doses, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.

Stopping dosulepin

Do not stop taking dosulepin without talking to your doctor. You may get withdrawal symptoms, especially if you stop taking it suddenly. These side effects are a reaction to coming off the medicine.

The side effects are usually harmless but unpleasant. They may include headaches, flu-like symptoms, feeling sick, finding it hard to sleep, and feeling restless or anxious.

If you and your doctor agree that you should stop taking dosulepin, your doctor will probably recommend reducing your dose gradually over several weeks.

If you're switching to another medicine, your doctor will explain how to introduce it slowly.

If you take too much

you take more than your prescribed dose of dosulepin – even if you do not have any symptoms

You can get serious side effects within a few hours and may need urgent hospital treatment.

Go to 111.nhs.uk or call 111

If you need to go to A&E, do not drive. Ask someone to drive you or call 999 and ask for an ambulance.

Bring the dosulepin packet or leaflet inside it, any remaining medicine, and any other medicines you take.

Common side effects

These common side effects of dosulepin happen in more than 1 in 100 people. There are things you can do to help cope with them:

Eat more high-fibre foods, such as fresh fruit and vegetables and cereals. Try to have several glasses of water, or other non-alcoholic drinks, every day. If you can, it may also help to do some exercise.

This is probably because of low blood pressure (hypotension). Drink plenty of water or non-alcoholic drinks. Do not stand up too quickly after sitting or lying down.

Chew sugar-free gum or suck sugar-free sweets.

Take dosulepin in the evening and try to cut down the amount of alcohol you drink. Do not drive or use tools or machinery if you're feeling sleepy. If this does not help, talk to your doctor.

Relax when you try to pee. Do not try to force the flow of urine. If you cannot go, try again later. Talk to your doctor, urgently, if you cannot pee at all.

Make sure you rest and drink plenty of fluids. Try not to drink too much alcohol. Talk to your doctor if the headaches last longer than a week or are severe.

Do not drive, cycle or operate machinery if this happens to you. This may improve as your body gets used to the medicine, but if it does not get better after 1 week, talk to your doctor as they may need to prescribe a different medicine.

If this advice does not help and any of these side effects continue, tell your doctor or pharmacist.

Serious side effects

Serious side effects after taking dosulepin are rare but there are some risks. There is an increased risk of heart problems.

Call your doctor call 111 now if:

your heart is beating faster or in an irregular way
the whites of your eyes turn yellow, or your skin turns yellow although this may be less obvious on brown or black skin – this can be a sign of liver problems
you have constant headaches, long-lasting confusion or weakness, or frequent muscle cramps – these can all be signs of low sodium levels in your blood
you get eye pain, a change in your eyesight, or swelling or redness in or around the eye
you have severe constipation or you're unable to pee

you have thoughts about harming yourself or ending your life

weakness on one side of your body
trouble speaking or thinking
loss of balance, or blurred eyesight

These can be signs of a stroke.

A&E safety messaging (for 999 only)

In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to dosulepin.

Meds New IA (H4) - serious allergic reaction

These are not all the side effects of dosulepin. For a full list, see the leaflet inside your medicine packet.

Dosulepin and pregnancy

Dosulepin is rarely taken during pregnancy, so its effects are not well known.

It's important that your mental health is well treated during pregnancy as it can affect you and your baby's wellbeing. Depression and anxiety can sometimes get worse during pregnancy and after your baby is born.

Talk to your doctor if you are taking dosulepin and are planning a pregnancy or become pregnant. They will help you weigh up the risks and benefits so you can decide on the best treatment for you and your baby.

Dosulepin and breastfeeding

If your doctor or health visitor says your baby is healthy, you can take dosulepin while breastfeeding.

Dosulepin passes into breast milk in very small amounts and has not been linked with side effects in breastfed babies.

Although other medicines might be preferred while you are breastfeeding, it is important you take the medicine that works for you. Talk to your doctor or pharmacist to help you decide.

It is important to continue taking dosulepin to keep you well. Breastfeeding will also benefit both you and your baby.

If you notice that your baby is not feeding as well as usual, seems unusually sleepy, restless or irritable, is constipated or not peeing as much, or if you have any other concerns about your baby, then talk to your health visitor, pharmacist or doctor as soon as possible.

Dosulepin and fertility

There's no clear evidence to suggest that taking dosulepin will reduce fertility in either men or women.

However, speak to a pharmacist or your doctor before taking it if you're trying to get pregnant.

Meds New IA (H2) - Pregnancy non-urgent care card

Cautions with other medicines

Many medicines can affect the way dosulepin works, and dosulepin can affect how other medicines work. Taking it with other medicines can increase the chances of side effects, and in some cases, cause serious side effects.

Make sure your doctor and pharmacist know what other medicines you are taking. This is important when you start or stop any other medicines, or when you have the dose changed.

Mixing dosulepin with herbal remedies and supplements

Do not take St John's wort, a herbal remedy for depression, while you're taking dosulepin. It'll increase your risk of side effects.

There's not enough information to say that other herbal remedies and supplements are safe to take with dosulepin. They're not tested in the same way as pharmacy and prescription medicines. They're generally not tested for the effect they have on other medicines.

OLD Meds - Cautions with other medicines alert