Dothiepin hydrochloride

Dosulepin hydrochloride (former British Approved Name (BAN) dothiepin hydrochloride) is indicated in depressive illness; particularly where sedation is required.

Contra indications include recent myocardial infarct, heart block, mania; porphyria.

Side effects include a dry mouth, sedation, blurred vision, constipation, nausea, difficulty with micturition. Cardiovascular side effects include arrhythmias, postural hypotension, syncope. Other side effects include sweating, tremor, rashes, behavioural disturbances - especially in children, interference with sexual function, hypomania, and confusion - especially in the elderly.

Uncommon side effects include black tongue, paralytic ileus, agranulocytosis, leucopenia, eosinophilia, purpura, thrombocytopenia, and jaundice.

The summary of product characteristics should be consulted before prescribing this drug.

Notes:

• dosulepin, phenelzine, combined antidepressants, and lithium augmentation of antidepressants should only be routinely initiated by specialist mental health professionals, including General Practitioners with a Special Interest in Mental Health (1)

Reference:

1. NICE (December 2004).Depression Management of depression in primary and secondary care