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Antidepressant medications are commonly prescribed to manage depression and various mental or mood disorders. They can significantly reduce the risk of suicidal thoughts or attempts and offer other crucial benefits. Nonetheless, research indicates that a small segment of individuals, particularly those under 25, may experience intensified depression, mental or mood symptoms, or suicidal thoughts or behaviors when taking antidepressants for any condition. It is crucial to discuss the potential risks and advantages of these medications with your healthcare provider, especially if you are under 25, regardless of whether the treatment is for a mental or mood disorder.

• Contact your doctor immediately if you observe any worsening of depression, changes in psychiatric condition, or unusual behavioral changes such as suicidal thoughts or attempts.
• Be alert for new or aggravated symptoms such as anxiety, panic attacks, sleep disturbances, irritability, hostility, impulsive actions, extreme restlessness, or rapid speech.
• Increased vigilance is advised when beginning a new antidepressant or adjusting the dosage.

Maintaining open communication with your healthcare provider is essential to managing your treatment safely and effectively.

You might experience some mild side effects such as drowsiness, dizziness, dry mouth, blurred vision, constipation, or difficulty urinating. These are generally not serious but if they persist or worsen, it's important to inform your healthcare provider. To minimize dizziness or lightheadedness, try standing up slowly after sitting or lying down. For dry mouth relief, consider using sugarless candy or gum, ice chips, or a saliva substitute, and stay hydrated. Incorporating dietary fiber, staying hydrated, and regular exercise can help prevent constipation; consult with your pharmacist about suitable laxatives if needed.

Serious side effects, although less common, must be addressed quickly. Contact your healthcare provider if you experience persistent heartburn, changes in mood or mental state such as anxiety or confusion, shaking, or severe stomach pain. Seek immediate medical attention for very serious side effects like severe dizziness, irregular heartbeat, fainting, seizures, or vision changes including seeing rainbows around lights. In rare cases, an allergic reaction may occur, which requires urgent medical attention. Symptoms include rash, swelling (especially of the face, tongue, or throat), severe dizziness, and breathing difficulties.

While this summary includes many potential side effects, it is not an exhaustive list. If you experience any symptoms not mentioned, reach out to your healthcare provider for advice.

Certain medications may interact with this drug. These include thyroid supplements and medications used to manage high blood pressure centrally, like Clonidine and Guanabenz. Combining this medication with MAO inhibitors can result in a severe, potentially life-threatening interaction. Do not use MAO inhibitors such as isocarboxazid, Linezolid, Metaxalone, methylene blue, moclobemide, phenelzine, procarbazine, Rasagiline, safinamide, Selegiline, or Tranylcypromine while taking this drug. Most MAO inhibitors should also be avoided for two weeks before and after using this medication. Consult your doctor about when it is safe to start or stop this medication.

Other drugs can influence how your body processes doxepin, affecting its efficacy. These include Cimetidine, St. John's Wort, medications for irregular heart rhythms (like quinidine, Propafenone, Flecainide), and certain antidepressants (such as SSRIs like paroxetine, Fluoxetine, Fluvoxamine). This list is not exhaustive.

Additionally, many drugs besides doxepin can impact heart rhythm (QT prolongation on an EKG), including Amiodarone, Dofetilide, Pimozide, procainamide, quinidine, Sotalol, and macrolide antibiotics like Erythromycin. Before starting doxepin, inform your doctor or pharmacist about all the medications you are taking.

Let your healthcare provider know if you are using other products that cause drowsiness, such as opioid pain or cough medications (like codeine, hydrocodone), alcohol, marijuana, sleep or anxiety medications (such as Alprazolam, Lorazepam, Zolpidem), muscle relaxants (such as Carisoprodol, Cyclobenzaprine), or antihistamines (like Cetirizine, diphenhydramine). Always check the labels on your medications, including those for allergies or cold and cough, as they may contain ingredients that cause drowsiness. Consult your pharmacist about using these products safely.