dosulepin / Generic mfg. - LARVOL DELTA

Prevalence of Psychotropic Drug Treatment Interventions in Patients Undergoing Metabolic and Bariatric Surgery: A Retrospective Study. (PubMed, Obes Surg) - "Although only a minority of patients required psychotropic drug treatment interventions, monitoring psychotropic drug treatment is essential for safe and effective treatment post-MBS. Greater attention is needed regarding altered drug exposure, and plasma concentration monitoring may help optimize psychotropic pharmacotherapy in these patients."

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

Right bundle branch block with ST-segment elevation - myocardial infarction or not? (PubMed, Eur Heart J Case Rep) - No abstract available

Journal • Cardiovascular • Myocardial Infarction

Development and optimization of dothiepin hydrochloride-loaded nanostructured lipid carrier incorporated in situ nasal gel for enhanced brain-targeted antidepressant delivery. (PubMed, Naunyn Schmiedebergs Arch Pharmacol) - "In vivo studies confirmed enhanced antidepressant activity, with increased swimming and climbing times, reduced immobility, and higher brain serotonin (197.7 ± 5.78 pg/mg) and norepinephrine levels (1.72 ± 0.02 nM/mg). The developed NLC-based in situ nasal gel presents a promising non-invasive alternative to oral therapy, potentially improving patient compliance and therapeutic outcomes in depression management."

Journal • CNS Disorders • Depression • Psychiatry

Comparative Efficacy and Safety of SSRIs and TCAs in the Management of Major Depressive Disorder: A Prospective Observational Study. (PubMed, J Pharm Bioallied Sci) - "Dosulepin/Dothiepin (TCA) was most frequently prescribed antidepressant followed by escitalopram (SSRI). Dry mouth and weight gain were the most frequently reported adverse drug reactions (ADRs). Antidepressants used for therapy of MDD in our study were effective in clinical improvement, better compliance on long term basis except for side effect profile."

Journal • Observational data • CNS Disorders • Depression • Major Depressive Disorder • Mental Retardation • Mood Disorders • Psychiatry • Sleep Disorder • Xerostomia

Understanding Antidepressant Change Patterns in the UK Biobank (WCPG 2025) - "The preference for antidepressants changed markedly over time, shifting from dosulepin, fluoxetine, to citalopram in the depression group, and from dosulepin to amitriptyline in the non-depression group. A total of 82,633 individuals in the UK Biobank were prescribed at least one antidepressant. Of these, 28,332 had a depression diagnosis and 24,543 did not. The most commonly prescribed antidepressants were Selective Serotonin Reuptake Inhibitors, including citalopram and fluoxetine in individuals with depression, and Tricyclic Antidepressants like amitriptyline in those without."

CNS Disorders • Depression • Insomnia • Major Depressive Disorder • Mood Disorders • Psychiatry • Sleep Disorder

Drug-induced Parkinsonism Mimicking Parkinson´s Disease in Patients Treated with Flunarizine for Migraine (MDS Congress 2025) - "He was then prescribed with levodopa-carbidopa 125mg...Case 2: 68-year-old female, was prescribed with propranolol 20mg and flunarizine 10mg from our clinic for her frequent migraine episodes and was asked for follow-up in 3 months...Flunarizine was changed to dosulepin 25mg and followed in 2 months with minimal bradykinesia and mask face and resolved tremor. We should be cautious prescribing Flunarizine in elderly people, low-dose treatment, needed proper counselling beforehand regarding the likelyhood of motor adverse effects and regular monitoring of symptoms is needed. Early diagnosis cause reversal of symptoms and reduce the disease and economic burden of patients."

Clinical • CNS Disorders • Migraine • Movement Disorders • Pain • Parkinson's Disease

National prescribing trends for anti-depressants, anxiolytics and hypnotics 2010 to 2023 in England : analysis and findings (ECNP 2025) - "Greatest increases were in sertraline prescriptions 2.9 million in 2010 by 685% to 23.0 million in 2023; Duloxetine prescription increased 545% to 3.9 million prescriptions; and mirtazapine by 269% to 12.4 million prescriptions. Paroxetine prescriptions fell by 20% to 1.3 million...The largest falls in cost were 91% for escitalopram (£19.30(€22.58) to £1.66(€1.94) per prescription) and 86% for duloxetine £28.00(€32.76) to £3.79(€4.43) per prescription. Dosulepin increased by 437% to £13.31(€15.57) per prescription...Lorazepam, diazepam and chlordiazepoxide all demonstrate reduced use during that period down 23%,16%, and 88% respectively...Zopiclone fell by 14% to 4.5 million, with zolpidem falling by 14% to 630,000 and nitrazepam by 70% to 306,000 prescriptions...The cost of Temazepam (volume reduced by 2023 to 12% of 2010) increased by 496% from £3.58(€4.19) to £21.34(€24.97)/prescripton...Reasons for increased antidepressant use may..."

CNS Disorders • Depression • Psychiatry

An Overview of the Systematic Reviews About the Efficacy of Fluvoxamine on Depression. (PubMed, Pharmaceuticals (Basel)) - "Comparisons with imipramine, clomipramine, amitriptyline, dothiepin, paroxetine, fluoxetine, citalopram, mianserin, nortriptyline, and moclobemide generally revealed no significant differences in efficacy. However, some reviews indicated that venlafaxine and mirtazapine were superior to fluvoxamine in certain outcomes, while fluvoxamine demonstrated greater efficacy than desipramine in one review. Sertraline and milnacipran showed mixed or review-quality-dependent results, with one low-quality review favoring milnacipran...While no single antidepressant was universally superior, fluvoxamine's unique pharmacological profile and favourable safety characteristics support its clinical utility. Further research is needed to explore its role in personalized treatment strategies and emerging therapeutic contexts, such as comorbid anxiety and post-traumatic stress disorder."

Journal • Review • CNS Disorders • Depression • Mental Retardation • Mood Disorders • Post-traumatic Stress Disorder • Psychiatry

Systematic review of pharmacotherapy for atypical facial pain: evaluation of pain reduction, depression, anxiety and quality of life. (PubMed, Ann Med) - "Antidepressants such as dothiepin and clomipramine demonstrated significant pain reduction, whereas venlafaxine showed limited efficacy. However, onabotulinum toxin A and sumatriptan exhibited inconsistent or minimal effects on AFP pain intensity...Given the variability in response and adverse events, a multimodal approach combining pharmacological and non-pharmacological therapies may offer the most effective management strategy. Future research should focus on standardized treatment protocols, long-term efficacy, and personalized treatment plans to optimize patient care."

HEOR • Journal • Review • CNS Disorders • Depression • Mood Disorders • Pain • Psychiatry • Xerostomia

Effect of Venlafaxine Versus Dosulepin in Pain Predominant Somatic Symptom Disorder (clinicaltrials.gov) - P4 | N=84 | Recruiting | Sponsor: All India Institute of Medical Sciences, Bhubaneswar | Not yet recruiting ➔ Recruiting

Enrollment open • Inflammation • Pain • Psychosomatic Disorders

Effect of Venlafaxine Versus Dosulepin in Pain Predominant Somatic Symptom Disorder (clinicaltrials.gov) - P4 | N=84 | Not yet recruiting | Sponsor: All India Institute of Medical Sciences, Bhubaneswar

New P4 trial • Inflammation • Pain • Psychosomatic Disorders

Drug-Induced Type 1 Brugada Pattern: A Case Report. (PubMed, Cureus) - "Dosulepin was discontinued and replaced with mirtazapine. Telemetry monitoring (24-hour ECG) showed normal sinus rhythm with no further Brugada pattern."

Journal • Cardiovascular • CNS Disorders • Depression • Epilepsy • Genetic Disorders • Psychiatry • Ventricular Tachycardia

Genetic Characterization of Clinical Trajectories in Major Depressive Disorder (WCPG 2024) - "For example, one trajectory (N=503) characterized by tobacco use and respiratory conditions, including COPD, had a higher polygenic risk for type 2 diabetes and was more likely to be treated with TCAs (amitriptyline, dosulepin). : Our study included 10,179 individuals with MDD and comprehensive EMR data (68% female; mean age at MDD onset: 50.8 years, range: 17-74 years). The average EMR length was 42 years, with 47 different ICD-10 codes per individual. The average duration of MDD was 6 years, with 4 MDD codes per individual."

Clinical • Cardiovascular • Chronic Obstructive Pulmonary Disease • CNS Disorders • Depression • Diabetes • Gastrointestinal Disorder • Genetic Disorders • Hypertension • Immunology • Major Depressive Disorder • Metabolic Disorders • Mood Disorders • Obesity • Psychiatry • Respiratory Diseases • Schizophrenia • Type 2 Diabetes Mellitus

Greener analysis of eleven basic drugs in blood and urine using carbowax 20M based biofluid sampler (BFS) device. (PubMed, J Chromatogr B Analyt Technol Biomed Life Sci) - "For the first time, a novel biofluid sampler (BFS) and sample preparation device is applied for the analysis of 11 basic drugs (i.e., pheniramine, chlorpheniramine, fluoxetine, tramadol, amitriptyline, ketamine, diazepam, chlordiazepoxide, clozapine, chlorpromazine, dothiepin) in biological matrices (i.e., blood and urine). Furthermore, the methodology has been effectively implemented in forensic toxicology case work. Moreover, the green characteristics and applicability of the suggested methodology was evaluated using softwares i.e., AGREE and BAGI."

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The cardiovascular safety of tricyclic antidepressants in overdose and in clinical use. (PubMed, Ther Adv Psychopharmacol) - "Amitriptyline, clomipramine, dothiepin/dosulepin, doxepin, trimipramine and imipramine showed broadly similar toxicity and were usually reported to be less toxic than desipramine...With respect to the risk of cardiovascular events at clinically relevant exposure, amitriptyline, nortriptyline and lofepramine were associated with a greater risk of in-use cardiotoxicity. All measures of overdose toxicity were subject to external influences and confounding. The continued use of TCAs in depression and other conditions should be minimized when considering their undoubted toxicity in overdose and possible toxicity in normal clinical use."

Journal • Review • Cardiovascular • CNS Disorders • Depression • Psychiatry

Effect of lipid emulsion on neuropsychiatric drug-induced toxicity: A narrative review. (PubMed, Medicine (Baltimore)) - "The following keywords were used to retrieve relevant case reports from PubMed: "antidepressant or antipsychotic drug or amitriptyline or bupropion or citalopram or desipramine or dosulepin or dothiepin or doxepin or escitalopram or fluoxetine or haloperidol or olanzapine or phenothiazine or quetiapine or risperidone or trazodone" and "lipid emulsion or Intralipid." Lipid emulsion treatment reversed the corrected QT interval prolongation and decreases in Glasgow Coma Scale scores caused by toxic doses of neuropsychiatric drugs, especially lipid-soluble drugs such as amitriptyline, trazodone, quetiapine, lamotrigine, and citalopram...Adjuvant lipid emulsion treatment contributed to the recovery of 98.30% of patients with neuropsychiatric drug-induced toxicity. However, further analyses using many case reports are needed to clarify the effects of lipid emulsion resuscitation."

Journal • Review • Anesthesia • Cardiovascular • CNS Disorders • Depression • Psychiatry

Brachioradial pruritus: a retrospective review (AAD 2024) - "About a third (32%, n=15) had complete remission. Amitriptyline, gabapentin and dothiepin cream were the most efficacious interventions in our cohort, supporting the theory of underlying nerve irritation or injury."

Retrospective data • Review • Dermatology • Musculoskeletal Pain • Pain • Pruritus

Comparative responses to 17 different antidepressants in major depressive disorder: Results from a 2-year long-term nation-wide population-based study emulating a randomized trial. (PubMed, Acta Psychiatr Scand) - "These analyses emulating a randomized trial of "real world" observational register-based data show that 2-year long-term non-responses to some antidepressants within six different drug classes are increased over others."

Journal • CNS Disorders • Depression • Major Depressive Disorder • Mood Disorders • Psychiatry

Improved Pharmacokinetic and Pharmacodynamic Profile of Deuterium-Reinforced Tricyclic Antidepressants Doxepin, Dosulepin, and Clomipramine in Animal Models. (PubMed, Eur J Drug Metab Pharmacokinet) - "Deuterated TCAs can prove to be potentially better molecules in the treatment of neuropsychiatric disorders as compared with nondeuterated compounds. In addition, we have demonstrated a concept that metabolically active, site-selective deuteration can be beneficial for improving the pharmacokinetic and pharmacodynamic profiles of TCAs. A further toxicological study of these compounds is needed to validate their future clinical use."

Journal • PK/PD data • Preclinical • CNS Disorders • Mental Retardation • Psychiatry

Antidepressant prescribing patterns and adverse events following introduction of a National Prescribing Indicator to monitor dosulepin usage in Wales. (PubMed, Br J Clin Pharmacol) - "Over half of patients had discontinued dosulepin at the end of the period when the NPI was in place. Further interventions may have been required to have a greater impact on prescribing. This study provides some reassurance that dosulepin discontinuation can be a successful strategy, and that the risk of the adverse events investigated was unlikely to have been greater in those who had dosulepin discontinued than in those in whom dosulepin had been continued."

Adverse events • Journal

Multi-dimensional relationships among dementia, depression and prescribed drugs in England and Wales hospitals. (PubMed, BMC Med Inform Decis Mak) - "Our analyses reveal a complex, multifaceted set of interactions among prescribed drug types, dementia subtypes, and depression."

Journal • Alzheimer's Disease • CNS Disorders • Dementia • Depression • Frontotemporal Lobar Degeneration • Immunology • Mood Disorders • Psychiatry

Synchronous LC-MS/MS determination of pantoprazole and amitriptyline in rabbit plasma: application to comparative in vivo pharmacokinetic study of novel formulated effervescent granules with its marketed tablet dosage form. (PubMed, Heliyon) - "Separation and detection of pantoprazole, amitriptyline and internal standards namely omeprazole and dothiepin, respectively, were achieved at ambient column temperature on C. Acetonitrile: 4mM ammonium acetate solution (comprising 0.05 % formic acid) (40:60, v/v) was used as mobile phase and the flow rate of 0.6 mLmin was applied. A single period randomized open-label parallel design was applied on Chancellor's rabbit. The selected formula showed superior pharmacokinetic parameters for pantoprazole and amitriptyline than that of marketed products."

Journal • PK/PD data • Preclinical

Tricyclic antidepressants versus 'active placebo', placebo or no intervention for adults with major depressive disorder: a protocol for a systematic review with meta-analysis and Trial Sequential Analysis. (PubMed, Syst Rev) - "Tricyclic antidepressants are recommended by clinical guidelines and frequently used worldwide in the treatment of major depressive disorder. There is a need for a thorough systematic review to provide the necessary background for weighing the benefits against the harms. This review will ultimately inform best practice in the treatment of major depressive disorder."

Journal • Retrospective data • Review • CNS Disorders • Depression • Major Depressive Disorder • Mental Retardation • Mood Disorders • Psychiatry

Beneficial and harmful effects of antidepressants versus placebo, 'active placebo', or no intervention for adults with major depressive disorder: a protocol for a systematic review of published and unpublished data with meta-analyses and trial sequential analyses. (PubMed, Syst Rev) - "As antidepressants are commonly used to treat major depressive disorder in adults, a systematic review evaluating their beneficial and harmful effects is urgently needed. This review will inform best practice in treatment and clinical research of this highly prevalent and burdensome disorder."

Clinical • Journal • Review • CNS Disorders • Depression • Major Depressive Disorder • Mental Retardation • Mood Disorders • Psychiatry • Suicidal Ideation

Application of Bar Adsorptive Microextraction for the Determination of Levels of Tricyclic Antidepressants in Urine Samples. (PubMed, Molecules) - "This work entailed the development, optimization, validation, and application of a novel analytical approach, using the bar adsorptive microextraction technique (BAμE), for the determination of the six most common tricyclic antidepressants (TCAs; amitriptyline, mianserin, trimipramine, imipramine, mirtazapine and dosulepin) in urine matrices. The developed and validated methodology was successfully applied for screening the six TCAs in real urine matrices. The proposed analytical methodology proved to be an eco-user-friendly approach to monitor trace levels of TCAs in complex urine matrices and an outstanding analytical alternative in comparison with other microextraction-based techniques."

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