Common questions about dosulepin

Dosulepin is from a group of antidepressants called tricyclic antidepressants.

For depression, it's thought to work by increasing levels of a chemical called serotonin in the brain. This can improve your mood.

For pain or preventing migraines, dosulepin can change the way your nerves receive pain signals. This can help with some kinds of nerve pain, including fibromyalgia. It can also help prevent migraine attacks.

Do not expect to feel better overnight. Some people feel worse during the first few weeks of treatment before they feel better.

For depression, it usually takes 4 to 6 weeks for dosulepin to work fully. It usually takes 2 to 6 weeks if you are taking dosulepin for pain or migraine.

Talk to your doctor if you're not feeling any better after taking dosulepin for 6 weeks, if you're worried about side effects, or if you're having thoughts of harming yourself.

For depression, dosulepin helps to lift your mood so you feel better. You may notice that you sleep better and are feeling less anxious.

Dosulepin will not change your personality. It'll simply help you feel like yourself again.

Some people feel a little drowsy with dosulepin, which is why it may be better to take it in the evening.

Dosulepin is safe to take for a long time as long as you're not getting side effects. There do not seem to be any lasting harmful effects from taking it for many months and years.

Dosulepin is not recommended for new patients now. It can be harmful for some people and is very dangerous if you take too much.

It's still sometimes prescribed for people who are already using it who have not had serious side effects.

If you have not had it before, it's unlikely to be prescribed for you. A specialist (such as a psychiatrist or a pain consultant) might prescribe it if other medicines have not worked and they think it's the best choice for you.

Dosulepin does not work any better or worse than other antidepressants, though sometimes people respond better to one antidepressant than another. But it is not often prescribed now because of the greater risk of serious heart problems if you're taking a higher dose.

It may be safer to take a different antidepressant in the tricyclic group, such as amitriptyline, or another type of antidepressant.

Talk to your doctor if you are not feeling any better on dosulepin or you're worried about side effects.

If you have been taking dosulepin for a while, your doctor may suggest trying a different medicine instead.

There are many alternative antidepressants to dosulepin now. They are safer and have fewer side effects. It's also possible you'll no longer need to take an antidepressant at all.

But if dosulepin works for you and you have not had any serious side effects with it, your doctor may still prescribe it for you if a consultant or another health specialist agrees this is still the best treatment option for you.

Dosulepin is sometimes used to treat some types of nerve pain, such as fibromyalgia, or to prevent migraine. But it's not recommended for, or officially approved for, pain relief.

Because of this, your doctor will probably prescribe other medicines. If you're already taking dosulepin, they may suggest switching to something else.

Other possible treatments include:

• painkillers, like paracetamol or co-codamol
• some antidepressants that also help with pain, such as amitriptyline
• medicines that are usually used for epilepsy, such as pregabalin
• medicines that are usually used to treat high blood pressure, such as bisoprolol

Your doctor may also suggest physiotherapy as an alternative.

Finding the most suitable treatment depends on how long you have had the pain, your symptoms, and what medicines have and have not worked for you in the past.

Antidepressants, including dosulepin, are just one of several approaches to treating depression. Other potential treatments include:

• talking therapy such as cognitive behavioural therapy (CBT)
• exercise programmes
• help to get a good night's sleep

Choosing a treatment that's most suitable for you depends on:

• how long you have had depression
• your symptoms
• whether you have had depression before
• whether previous treatment has worked
• how likely you are to stick with your treatment
• the potential side effects
• your preferences and priorities

If you're interested in any of these treatments, talk to your doctor.

Dosulepin is not addictive, but you may get withdrawal symptoms when you stop taking it, especially if you stop taking it suddenly. These withdrawal symptoms are the side effects of coming off the medicine.

The side effects are usually harmless but unpleasant. They may include headaches, flu-like symptoms, feeling sick, finding it hard to sleep, and feeling restless or anxious.

To help prevent these side effects, your doctor will probably recommend reducing your dose gradually over several weeks.

Dosulepin can change how hungry you feel. Some people feel more hungry when they're taking it, and others feel less hungry. So your weight may change when you first start taking it.

If you start to have problems with your weight while taking dosulepin, talk to your doctor or pharmacist.

Dosulepin does not affect any type of contraception, including the combined pill or emergency contraception.

The good effects of dosulepin may, after a while, improve your sex life as your mood lifts and you become interested in life and relationships again.

Some of the possible negative effects include:

• problems with getting an erection and problems ejaculating
• some vaginal bleeding
• breast swelling

Sexual side effects are not common and should pass after the first couple of weeks. If they do not and this is a problem for you, go back to your doctor to see if there's another antidepressant you can try.

If you're a woman and you get vaginal bleeding after the menopause, make an appointment to see your doctor as soon as possible.

Some people feel sleepy while they're taking dosulepin. If this happens to you, do not drive, cycle or use machinery or tools until you feel better.

It's an offence to drive a car if your ability to drive safely is affected. It's your responsibility to decide if it's safe to drive. If you're in any doubt, do not drive.

Talk to your doctor or pharmacist if you're unsure whether it's safe for you to drive while taking dosulepin. GOV.UK has more information on the law on drugs and driving.

You can drink alcohol while taking dosulepin, but it may make you feel sleepy. It might be best to stop drinking alcohol until you see how the medicine makes you feel.

The serious side effects of dosulepin can be made worse by binge drinking. If you're drinking alcohol with dosulepin, it's best to cut down the amount you drink.

You can eat and drink normally while taking dosulepin.

Taking cannabis with dosulepin can make you feel very sleepy, especially if you have just started taking the medicine. Using the two together can also give you a fast heartbeat.

It can be dangerous to take dosulepin with:

• methadone
• stimulants like MDMA (ecstasy) or cocaine
• hallucinogens like LSD
• novel psychoactive substances (which used to be known as legal highs) like mephedrone

Dosulepin has not been properly tested with recreational drugs. Talk to your doctor if you think you might use recreational drugs while taking dosulepin.

Find out more about the side effects of some recreational drugs on the Frank website.