Dothiepin
Risk Factor: D
Class: CENTRAL NERVOUS SYSTEM DRUGS
/ Antidepressants
Contents of this page:
Fetal Risk Summary
Breast Feeding Summary
References
Questions and Answers
Fetal Risk Summary
No data are available. See Imipramine.
Breast Feeding Summary
Dothiepin is excreted into human breast milk (1,2). In one patient treated with dothiepin, 25 mg three times a day for 3 months, milk and maternal serum concentrations 3 hours after the second dose of the day were 11 and 33 ng/mL (ratio 0.33) (1). A second woman, treated intermittently over a 6-day period with a total dose of 300 mg, had a milk level of 10 ng/mL (1). Effects of this exposure in the nursing infants were not mentioned.
Milk concentrations of dothiepin and three metabolites were measured in eight postpartum women being treated for depression with dothiepin, 25225 mg/day (2). Some of the women had apparently taken the drug during pregnancy but details of the treatment and pregnancy outcome were not given. The ages of the nursing infants ranged from 0.13 to 12.5 months. Milk samples were collected from the women just before and immediately after breast feeding. Plasma samples were collected at periods ranging from 2.8 to 15.8 hours after a dose. The mean milk:plasma ratios before feeding for dothiepin, nordothiepin, dothiepin-S-oxide, and nordothiepin-S-oxide were 0.78, 0.85, 1.18, and 1.86, respectively. The milk:plasma ratios for the metabolites in the post-feed samples were similar to those before feeding, but dothiepin was significantly higher (1.59; p<0.05). The authors calculated that a nursing infant would ingest approximately 0.58% of the mother's daily dothiepin dose and amounts varying from 0.23% to 2.47% of the metabolites. No adverse effects were observed in the infants. However, the American Academy of Pediatrics classifies dothiepin as an agent whose effect on the nursing infant is unknown but may be of concern, especially if therapy is prolonged (3).
References
- Rees JA, Glass RC, Sporne GA. Serum and breast milk concentrations of dothiepen. Practitioner 1976;217:686.
- Ilett KF, Lebedevs TH, Wojnar-Horton RE, Yapp P, Roberts MJ, Dusci LJ, Hackett LP. The excretion of dothiepin and its primary metabolites in breast milk. Br J Clin Pharmacol 1992;33:6359.
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Committee on Drugs, American Academy of Pediatrics. The transfer of drugs and other chemicals into human milk. Pediatrics 1994;93:13750.
Questions and Answers
What are the effects on the body if drinking a bottle of wine a day and taking Dothiepin?, I feel there are mood swings. I also feel my boyfriend may have ADHD or be a Manic Depressive. This affects our relationship since some of the time he wants freedom, which he has, then other times he wants me around all the time. I just don't get it and I feel used. But I want to make sure I am not being horrible if there is a problem. He has been taking anti-depressants for years now.
dothiepin might react to artomelcines present in some red wines (mostly wines from the western regions of the calamines)
Can you take two antidepressants at the same time? A doctor want a person to take Dothiepin and Prozac?, A doctor wants Fluxoetine and Dothiepin (dosepin) taken together since allows the person to sleep better whilst the other to wake them up. I have not heard of this before and worry the patient has not been advised properly.
If I were you, I would get a second opinion. I would make sure that I went to a psychiatrist. They are the experts with these types of medicines. If you were having heart problems chances are you would go to a cardiologist instead of a family doctor. So do it for mental health also.
People can and do take two antidepressants at the same time. Sometimes one will be taken in the morning and the other at night. Some take them together at the same time.
Sometimes several similar medications are needed to stabilze a patient. Or if one is working some the other will be taken to get an increased effect.
With Prozac and Dothiepin they are in two different classes of antidepressants which make them safe to take. Prozac is an ssri while Dothiepin is a tricyclic antidepressant.
Both also have some "on the side" uses.
Prozac can be used for bulimia nervosa (an eating disorder) obsessive-compulsive disorder, panic disorder, premenstrual dysphoric disorder (PMDD) and major depression.
Dothiepin can be used for painkiller to treat severe nerve pain and depression.
They do both have so similar side effects so it might be hard to figure out which on is causing them.
With all of that said, I personally take Effexir and Wellbutrin at the same time (in the morning) every day. I have also had Zoloft to take at night with them until Zoloft seemed to stop working. A lot of times several are needed to get the maximum effect.
