Dosulepin (dothiepin): what it does and what to watch for

Dosulepin, also called dothiepin, is a tricyclic antidepressant used for depression and some chronic pain or sleep problems. It can help mood and sleep, but it also comes with noticeable side effects and drug interactions. This page gives the straightforward facts you need so you can talk with your doctor from a strong place.

Quick facts: how it works, dose, and effects

Dosulepin changes brain chemicals that affect mood. Doctors usually start low (for example 25 mg a day) and may raise the dose over a few weeks. Typical adult doses often sit between 25–150 mg daily, split into one or two doses — but your prescriber will set this based on your health and response. Expect mood benefits to take 2–4 weeks in many people.

Common effects include drowsiness, dry mouth, constipation, blurred vision, and weight gain. Because it can make you sleepy or slow your reaction time, avoid driving or using machines until you know how it affects you. Older adults often feel stronger anticholinergic effects (confusion, urinary problems) and usually need lower doses or a different drug.

Safety, interactions and stopping safely

Dosulepin interacts with several medicines. Don’t combine it with MAO inhibitors, and be careful with SSRIs, SNRIs, and other drugs that raise serotonin — mixing can raise the risk of serotonin syndrome. It can also affect heart rhythm in some people, so doctors may order an ECG if you have heart disease or take other drugs that prolong QT.

Alcohol increases drowsiness and can lower the drug’s benefit, so it’s best to avoid drinking while taking dosulepin. Tell your prescriber about any other medicines, herbal supplements, or over-the-counter products you use.

Stopping suddenly can cause withdrawal symptoms like irritability, sleep trouble, flu-like feelings, or return of low mood. Most prescribers taper the dose down slowly over days to weeks to reduce these risks. If you get worse mood or new symptoms while reducing dose, contact your doctor right away.

If you’re pregnant, planning pregnancy, or breastfeeding, talk to your doctor — they’ll weigh the risks and benefits and may suggest an alternative if needed. For anyone with a history of heart disease, seizures, or severe urinary issues, dosulepin might not be the best choice.

Alternatives include SSRIs (like sertraline or fluoxetine) and SNRIs (like venlafaxine), which often have fewer anticholinergic effects. Which medicine fits best depends on your symptoms, other health problems, and side effect tolerance.

Want to buy medication online? Use a licensed pharmacy and keep your prescription handy. If something looks too cheap or the site doesn’t ask for a prescription, don’t risk it. Ask your pharmacist questions — they can explain dose, side effects, and safe storage.

Questions for your prescriber: Are there safer options for my age/health? What dose is best to start? How will we taper if I need to stop? Keep these ready before you start or change treatment.