TREATMENT DATABASE

CAUTION: Tricyclic antidepressants increase the amount of norepinephrine in the brain. They cannot be given in conjunction with MAOIs because of the risk of producing dangerously high blood pressure. The National Institutes of Health (NIH) does not recommend tricyclics for children or teens.

Sinequan (doxepin) is a tricyclic antidepressant. Tricyclics are named after their chemical structure, which contains three rings of atoms. Tricyclics were developed in the 1950s and are primarily prescribed for depression.

USES IN ME/CFS: Doxepin is one of the most commonly used medications in the treatment of  sleep disturbance. It is believed that doxepin may help correct the slow-wave sleep deficit found in both ME/CFS and fibromyalgia. Improvement in sleep often brings an increase in energy levels and reduction in the pain associated with ME/CFS and fibromyalgia. Many patients also report improvement in allergies as a result of doxepin's potent histamine-blocking properties. Dr. Cheney believes that doxepin at low doses may function as an immune modulator. By softening immune system activation, doxepin can relieve sore throats, swollen glands and congestion.

Most patients report improved quality of sleep, better endurance, and energy. While some patients experience daytime sedation during the first few days, this problem usually resolves rapidly. Benefits are often noted fairly quickly, within a few days.

Side effects include weight gain, constipation, and dry mouth. Too high a dose can result in nightmares. Many patients report excessive sedation or a drugged feeling and therefore cannot tolerate treatment. Paradoxically, some feel depressed after taking the drug (but not before).

Treatment rating for Sinequan (doxepin)