doxepin / Generic mfg. - LARVOL DELTA

Real-world data on the abuse potential of medications for the treatment of insomnia: a disproportionality analysis of the FAERS database. (PubMed, Front Pharmacol) - "Drugs of interest included Schedule IV drugs (benzodiazepines, Z-drugs, dual orexin receptor antagonists [DORAs]) and non-scheduled drugs (trazodone, doxepin, ramelteon)...This study identified significantly fewer reported cases of real-world abuse, misuse, overdose, and other safety risks for DORAs compared with the unscheduled drug trazodone and scheduled Z-drugs. This suggests that categorization of DORAs as Schedule IV drugs may overstate their abuse potential."

Journal • Real-world evidence • CNS Disorders • Insomnia • Sleep Disorder

Clinical evidence for managing radiotherapy-induced oral mucositis and xerostomia in head and neck cancer patients: a review of Phase III-IV trials. (PubMed, Int J Oral Maxillofac Surg) - "For oral mucositis, effective pharmacological agents included palifermin, avasopasem manganese, doxepin, morphine mouthwash, and gabapentin, while non-pharmacological options such as low-level laser therapy, honey, and Aloe vera showed additional benefit in reducing severity and improving healing. In managing radiotherapy-induced xerostomia, pilocarpine, amifostine, and cevimeline significantly enhanced salivary function, with adaptive radiotherapy techniques offering protective effects on the salivary glands...Although several interventions demonstrated promising clinical efficacy, the heterogeneity in study design, outcome measures, and follow-up duration limits definitive conclusions. Therefore, customized, evidence-driven approaches informed by existing recommendations and developed data are crucial for enhancing outcomes and reducing the burden of therapy-induced toxicities in head and neck cancer patients."

Journal • P3 data • Review • Dental Disorders • Head and Neck Cancer • Mucositis • Oncology • Oral Cancer • Solid Tumor • Stomatitis • Xerostomia

Prefrontal cortex-extracellular vesicle RNAs coupling in alcohol use disorder: towards non-invasive biomarkers and targeted therapeutics. (PubMed, Artif Cells Nanomed Biotechnol) - "Computational drug repurposing identified loratadine, doxepin, citalopram and imipramine as promising therapeutic candidates targeting SERPINA3. Collectively, this work delineated PFC signature genes, proposed a EVs-supported brain-periphery molecular crosstalk, and provided translatable biomarkers and repurposable candidates for AUD precision medicine."

Biomarker • Journal • Addiction (Opioid and Alcohol) • IL17A • SERPINA3

Tricyclic Antidepressants as Prospective α-Synucleinopathy Fighters: Evidence of Protein Binding and Antiaggregation Activity. (PubMed, ACS Chem Neurosci) - "Here, we report the finding that clinically approved tricyclic antidepressants imipramine, amitriptyline, and doxepin bind directly to monomeric α-synuclein and inhibit its fibrillation, a key process in Parkinson's pathology...Moreover, simulations show that a single ligand molecule frequently engages in simultaneous salt-bridge and π-stacking interactions, unlike some previously studied α-synuclein binders. Our findings position tricyclic antidepressants as promising scaffolds for targeting α-synuclein and demonstrate the efficiency of molecular dynamics approaches for the description of interactions between small drug molecules and IDPs."

Journal • CNS Disorders • Movement Disorders • Parkinson's Disease

Dose-dependent pharmacological mechanisms within the Neuroscience-based Nomenclature: a new concept to facilitate neuroscience-based prescribing. (PubMed, Lancet Psychiatry) - "Using the Neuroscience-based Nomenclature (NbN) framework, which classifies drugs by pharmacology and modes of action, we identified ten agents demonstrating DDDP in a comprehensive expert-based consensus process: amisulpride, amitriptyline, aripiprazole, brexpiprazole, cariprazine, doxepin, mirtazapine, quetiapine, risperidone, and trazodone...Understanding these differences supports more rational prescribing (eg, increasing dopamine partial agonist doses beyond the optimal range might reduce efficacy). DDDP, within the NbN framework, offers a neuroscience-based approach to more precise psychopharmacology."

Journal • Review • NBN

Dutch Pharmacogenetics Working Group (DPWG) guideline for the gene-drug interaction between CYP2D6 and CYP2C19 and tricyclic antidepressants. (PubMed, Eur J Hum Genet) - "For CYP2D6 poor metabolisers (PM), dose reductions are advised for amitriptyline (reduction to 60% of the normal dose), clomipramine (reduction to 50% of the normal dose for the indication depression or in case of side effects at the normal dose for the other indications), doxepin (reduction to 40% of normal dose), imipramine (30% of the normal dose), and nortriptyline (40%)...The DPWG classifies CYP2D6 genotyping for all five TCAs and CYP2C19 genotyping for clomipramine in patients with anxiety disorders or OCD, and for imipramine as being "potentially beneficial". Genotyping prior to treatment can be considered on an individual patient basis."

Biomarker • Journal • CNS Disorders • Depression • Mood Disorders • Obsessive-Compulsive Disorder • Psychiatry • CYP2C19

Evaluating the Safety of Prescription Sleep Medications in Patients Undergoing Total Knee Arthroplasty: A Propensity Matched Analysis. (PubMed, J Am Acad Orthop Surg) - "Use of any prescription sleep medication or only standard sleep medications is associated with increased surgical complications. Additional research is needed to find medications that may be safer for routine postoperative use."

Journal • CNS Disorders • Musculoskeletal Diseases • Orthopedics • Pain • Psychiatry • Sleep Disorder

Doxepin and Mirtazapine Use in Children and Adolescents With Symptoms of Insomnia - A Single-Center Retrospective Review. (PubMed, Pediatr Neurol) - "We found both doxepin and mirtazapine as effective and tolerable treatments options in improving subjective sleep onset and maintenance issues in children with insomnia."

Journal • Retrospective data • CNS Disorders • Insomnia • Pediatrics • Sleep Disorder

Targeted interventions to promote sleep for hospitalized older adults: a narrative review. (PubMed, Hosp Pract (1995)) - "Sleep promotion should include, at a minimum, non-pharmacological interventions (e.g. increasing familiarity, reducing sensory stimulation as bedtime approaches, maintaining environmental and behavioral zeitgebers). Pharmacological (e.g. ramelteon, trazadone, doxepin, dual orexin receptor antagonists) and nutraceutical (e.g. melatonin, magnesium) interventions may be appropriate, Certain pharmacological options are considered potentially unsafe for older adults (e.g. benzodiazepines, Z-drugs, antihistamines) and should be avoided in this population."

Journal • Review • Alzheimer's Disease • CNS Disorders • Dementia

Undiagnosed Delusional Infestation Leading to Severe Self-Inflicted Injuries: A Case Report. (PubMed, Case Rep Psychiatry) - "Treatment with low-dose risperidone and doxepin was initiated following empathic, nonconfrontational engagement...This case highlights the risk of severe self-injury in DI and underscores the need for timely psychiatric evaluation and a compassionate, collaborative approach. Reframing treatment goals to prioritize symptom relief over delusional challenge may enhance engagement and facilitate recovery."

Journal • Dermatology • Pruritus • Psychiatry • Thermal Injury

The use of antihistamine and antihistamine-like drugs for cancer-related pain: a narrative review. (PubMed, Support Care Cancer) - "Analysis of these studies demonstrated meaningful evidence that antihistamine and antihistamine-like drugs may offer some benefit for treating cancer-related pain."

Journal • Review • Mucositis • Oncology • Pain • Peripheral Neuropathic Pain • Stomatitis

Sleep-promoting effects and mechanisms of Bacillus coagulans IDCC 1201: evidence from pentobarbital-induced sleep and electroencephalography analysis in mice. (PubMed, Food Funct) - "Delta activity analysis indicated no adverse effects on sleep quality. These findings suggest that B. coagulans IDCC 1201 enhances sleep by modulating the GABAergic system and improving sleep architecture, highlighting its potential as a functional ingredient for sleep enhancement without the drawbacks of conventional sleep aids."

Journal • Preclinical • CNS Disorders • Infectious Disease

The Pharmacist's Role in Age-Friendly Mobility. (PubMed, Sr Care Pharm) - "Instead of doxepin, a highly anticholinergic antidepressant, the resident is effectively transitioned to escitalopram, resulting in a stable mood...Although the resident primarily presented with mobility issues, her case illustrates the interplay of all 4Ms and underscores the importance of a collaborative approach. This patient, whose main concern was mobility, required interventions to optimize medications and address mentation through the treatment of depression, all while maintaining a focus on what matters most to her as an individual."

Journal • Cardiovascular • CNS Disorders • Depression • Diabetes • Hypertension • Metabolic Disorders • Musculoskeletal Diseases • Orthopedics • Osteoporosis • Pain • Psychiatry • Rheumatology • Type 2 Diabetes Mellitus

Repurposed doxepin targeting host AXL kinase to disrupt viral 2C-mediated immune evasion in Coxsackievirus B infection. (PubMed, Antiviral Res) - "Furthermore, our findings unveiled a novel immune evasion mechanism employed by CVB, wherein AXL kinase modulates viral replication by regulating host immune signaling. These results highlight AXL as a critical host factor in CVB infection and provide a strong rationale for considering DH as a potential host-targeted therapeutic strategy for CVB-associated diseases, particularly in the absence of specific antiviral agents."

Journal • Cardiovascular • CNS Disorders • Infectious Disease • Inflammation • AXL • IL1B • IL6

A double layer oral film loaded with doxepin hydrochloride for the treatment of chemotherapy-induced oral mucositis. (PubMed, Front Pharmacol) - "Further investigation revealed that the healing mechanism involves the alleviation of oxidative stress and attenuation of excessive inflammatory responses. The doxepin hydrochloride patch developed in this study provides a novel pharmaceutical option for clinical management of CIOM."

Journal • Mucositis • Oncology • Pain • Stomatitis

The effects of antidepressants on cardiometabolic and other physiological parameters: a systematic review and network meta-analysis. (PubMed, Lancet) - "We found strong evidence that antidepressants differ markedly in their physiological effects, particularly for cardiometabolic parameters. Treatment guidelines should be updated to reflect differences in physiological risk, but choice of antidepressant should be made on an individual basis, considering clinical presentation and preferences of patients, carers, and clinicians."

Journal • Retrospective data • CNS Disorders • Mental Retardation • Metabolic Disorders • Psychiatry

Psychological Adverse Events and Associated Safety Profiles of Doxepin: A Pharmacovigilance Study Using VigiBase. (PubMed, J Korean Med Sci) - "Although no definitive safety signals were detected in our AESI analyses, we identified safety signal for drug abuse. Clinicians should carefully weigh the risks and benefits when prescribing doxepin and emphasize the need for vigilant monitoring of AEs."

Adverse events • Journal • CNS Disorders • Depression • Insomnia • Psychiatry • Sleep Disorder

Efficacy and safety of insomnia pharmacotherapies: Convergent evidence from Bayesian network meta-regression and FAERS-based disproportionality analysis. (PubMed, Sleep Med) - "Comprehensively considering the efficacy effect size, time windows (follow-up period, age, and types of insomnia), PV, severity of imperative adverse events, we propose prioritizing the use of daridorexant 25 mg/d for insomnia characterized by difficulty maintaining sleep and insufficient sleep duration. For insomnia characterized by difficulty falling asleep, we recommend prioritizing the use of lemborexant 10 mg/day or zolpidem 10 mg/day. For overall poor sleep efficiency, we recommend using lemborexant. Drug selection should be based on the types of insomnia and drug safety. More head-to-head clinical trials are needed to confirm those findings."

Journal • Review • CNS Disorders • Insomnia • Pulmonary Disease • Sleep Disorder

Adverse events of pharmacological interventions for insomnia disorder in adults: a systematic review and network meta-analysis. (PubMed, Front Psychiatry) - "Compared with placebo, zolpidem (somnolence: relative risk [RR] 1.85; dizziness: RR 2.33; headache: RR 1.26), zopiclone (somnolence: RR 2.02; dizziness: RR 2.33; dysgeusia: RR 7.84), indiplon (somnolence: RR 3.46; dizziness: RR 2.30; headache: RR 1.63), gaboxadol (dizziness: RR 3.44), eszopiclone (somnolence: RR 2.00; dizziness: RR 3.18; dysgeusia: RR 10.54), estazolam (somnolence: RR 2.08), flunitrazepam (somnolence: RR 3.04), flurazepam (somnolence: RR 2.52), lemborexant (somnolence: RR 6.57), nitrazepam (somnolence: RR 3.80), Ramelteon (somnolence: RR 2.19), suvorexant (somnolence: RR 3.32), Temazepam (somnolence: RR 3.77), trazodone (somnolence: RR 2.86), triazolam (somnolence: RR 2.35), and esmirtazapine (somnolence: RR 4.63; dizziness: RR 2.87) had the most harmful profile in nervous system disorders...Data on some drugs like flurazepam, nitrazepam, triazolam, and zaleplon in some outcomes were mainly based on limited study with rare event and thus was highly..."

Adverse events • Journal • Retrospective data • Review • CNS Disorders • Gastroenterology • Gastrointestinal Disorder • Infectious Disease • Insomnia • Otorhinolaryngology • Pain • Psychiatry • Respiratory Diseases • Sinusitis • Sleep Disorder • Xerostomia

Sulfonatocalixarene Promotes Drug Assembly Based on Supramolecular Host•-Guest Complexation in Aqueous Solution. (PubMed, Chem Asian J) - "Supramolecular nano-sized assemblies with high structural stability are designed based on hostguest complexation in aqueous solution using sulfonatocalix[n]arenes (SXCn) as macrocyclic hosts and three drug molecules (doxepin, desipramine, and promazine)...Despite the high-water solubility of SCX4 and the drug molecules, their combination reveals the formation of supramolecular assembly at low millimolar concentrations. These assemblies exhibit a thermoresponsive behavior, highlighting their potential for the design of functional materials."

Journal

Pharmacotherapy of psychiatric inpatients with mental and behavioral disorders caused by sedatives or hypnotics (F13): Results from an observational pharmacovigilance program between 2000 and 2017. (PubMed, Addict Sci Clin Pract) - "We found high rates of non-SHA drugs among patients treated for SHA-SUD. The prevalent use of psychotropic drugs with strong sedating properties indicates a symptom-oriented treatment approach, which is often "off-label" but may be clinically necessary. Main limitation is the cross-sectional design of the AMSP databank. Therefore, we cannot provide any follow up data on the patient collective especially regarding outcome."

Adverse events • Journal • Addiction (Opioid and Alcohol) • Behavior Disorders • CNS Disorders • Mental Retardation • Mood Disorders • Psychiatry

Design strategies for titanium surfaces to adsorb and release drugs: An in vitro study. (PubMed, Biomed Mater Eng) - "The results suggest that a rougher or ionically charged surface does not guarantee drug adsorption. In contrast, the use of a transport vehicle such as a polyvinyl coating ensures the release of the drug, initiating its therapeutic effect within the first minutes, and maintained for a period of between 120 and 180 min."

Journal • Preclinical • Inflammation • Pain

Carbon Materials in Voltammetry: An Overview of Versatile Platforms for Antidepressant Drug Detection. (PubMed, Micromachines (Basel)) - "Moreover, the combination of voltammetric approaches with the unique characteristics of carbon and its derivatives has led to the development of powerful electrochemical sensing tools for detecting antidepressant drugs, which are highly desirable in healthcare, environmental monitoring, and the pharmaceutical industry. In this review, carbon-based materials, such as glassy carbon and boron-doped diamond, and a wide spectrum of carbon nanoparticles, including graphene, graphene oxides, reduced graphene oxides, single-walled carbon nanotubes, and multi-walled carbon nanotubes were described in terms of the sensing performance of agomelatine, alprazolam, amitriptyline, aripiprazole, carbamazepine, citalopram, clomipramine, clozapine, clonazepam, desipramine, desvenlafaxine, doxepin, duloxetine, flunitrazepam, fluoxetine, fluvoxamine, imipramine, nifedipine, olanzapine, opipramol, paroxetine, quetiapine, serotonin, sertraline, sulpiride, thioridazine, trazodone, venlafaxine,..."

Journal • Review • CNS Disorders • Depression • Mood Disorders • Personality Disorder • Psychiatry

The effect of doxepin 3 mg on sleep latency: a pooled analysis of two phase 3 trials. (PubMed, Sleep Breath) - "Doxepin 3 mg has a statistically significant effect on sleep latency on the first night of treatment in adults with insomnia that did not reach the clinical significance threshold."

Clinical • Journal • P3 data • Retrospective data • CNS Disorders • Insomnia • Sleep Disorder

Trazodone versus doxepin as a pharmacologic sleep aid in psychiatric inpatients: A retrospective cohort study. (PubMed, Ment Health Clin) - "After treatment failure with trazodone 50 mg, there was no statistically significant difference in efficacy or tolerability between trazodone 100 mg and doxepin 25 mg for insomnia. A prospective trial would be necessary to directly compare the 2 treatment options."

Journal • Retrospective data • CNS Disorders • Insomnia • Psychiatry • Sleep Disorder