Doxepin is a tricyclic antidepressant, known under many brand-names such as Aponal®, the original preparation by Boehringer-Ingelheim, now part of the Roche group; Adapine®, Sinquan® and Sinequan® (Pfizer Inc.). As doxepin hydrochloride it is the active ingredient in cream based preparations (Zonalon® and Xepin®) for the treatment of dermatological itch.

Pharmacology

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Doxepin inhibits the reuptake of serotonin and noradrenaline from the synaptic cleft (dual action). The reuptake-inhibition of dopamine is very weak.

It has antagonistic effects (blockade) on a variety of postsynaptic receptors:

• Extremely strong : H1, H2
• Strong : 5-HT2, Alpha1, Muscarinic
• Moderate : 5-HT1
• Weak : D2, Alpha2

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