Sinequan (generic name: doxepin) is an elderly antidepressant that helps the brain increase norepinephrine at moderate doses and serotonin at higher doses. Sinequan is quite good for depression with

insomnia, weight loss, or irritability. It is used to treat unipolar major depression as well as anxiety, organic depression resulting from brain injury, depression caused by alcoholism, and psychotic depression. Sinequan also provides great benefits for people with heartburn or acid reflux, because it decreases the secretion of stomach acid. The liquid form is anesthetic, and it cools stomach pain on contact. Sinequan also can prevent migraine headaches, reduce pain resulting from diabetes and nerve damage, and minimize chronic pain in the neck, shoulders, and lower back (although it is not licensed for this purpose). Many patients like Sinequan and find it very effective.

Patients say that Sinequan keeps their negative emotions from escalating and their negative thoughts from going too far afield. It creates a slight dulling effect that is a great relief if your mind is overflowing with painful emotions and intrusive negative thoughts. Even at low doses, Sinequan can help improve your sleep. In fact, pharmaceutical companies are debating whether to release low-dose Sinequan as the sleeping tablet of the future.

On the downside, Sinequan is usually sedating during the day, at least at first. Sedation can be avoided or minimized by increasing the dose slowly and allowing your body to adjust. Sinequan can also cause weight gain, so it is important to watch your diet. It can make some people dizzy if they stand up quickly, so it is important to watch for this, especially in the first few weeks.

One advantage of Sinequan is that it can be given in very low doses to expose you to as few side effects as possible. For example, Sinequan is made in 10- and 25-milligram capsules (as well as 50, 75, 100, and 150-milligram sizes), although your pharmacist may not have all the sizes in stock. Sinequan is also available in an unflavored liquid form that is easy to take. It delivers 50 milligrams per teaspoonful, and it comes with a dropper that can measure smaller doses.

You usually start Sinequan at 10-25 milligrams and increase it to between 75 and 150 milligrams. Some patients may require higher doses (200-250 milligrams) to quell their depressive symptoms. After you stop taking Sinequan, it clears from your body in about two days. Some Sinequan is metabolized into the antidepressant called desmethyldoxepin, which stays around as many as five days. Sinequan is not recommended for elder adults, because its typical tricyclic antidepressant side effects may cause a risk of falls, sedation, or confusion.