Antidepressants, Tricyclic (Systemic)

Proper Use of This Medicine

To lessen stomach upset, take this medicine with food, even for a daily bedtime dose, unless your doctor has told you to take it on an empty stomach.

Take this medicine only as directed by your doctor , to benefit your condition as much as possible. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

Sometimes this medicine must be taken for several weeks before you begin to feel better . Your doctor should check your progress at regular visits.

To use doxepin oral solution :

• This medicine is to be taken by mouth even though it comes in a dropper bottle. The amount you should take should be measured with the dropper provided with your prescription and diluted just before you take each dose. Dilute each dose with about one-half glass (4 ounces) of water, milk, citrus fruit juice, tomato juice, or prune juice. Do not mix this medicine with grape juice or carbonated beverages since these may decrease the medicine's effectiveness.
• Doxepin oral solution must be mixed immediately before you take it. Do not prepare it ahead of time.

Dosing - The dose of tricyclic antidepressants will be different for different patients. Follow your doctor's orders or the directions on the label . The following information includes only the average doses of tricyclic antidepressants. If your dose is different, do not change it unless your doctor tells you to do so.

The number of capsules or tablets, or the amount of solution or syrup that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are taking tricyclic antidepressants .

For amitriptyline
• For tablet dosage form:
  • For depression:
    • Adults - At first, 25 milligrams (mg) two to four times a day. Your doctor may increase your dose gradually as needed. However, the dose is usually not more than 150 mg a day, unless you are in the hospital. Some hospitalized patients may need higher doses.
    • Teenagers - At first, 10 mg three times a day, and 20 mg at bedtime. Your doctor may increase your dose gradually as needed. However, the dose is usually not more than 100 mg a day.
    • Children 6 to 12 years of age - 10 to 30 mg a day.
    • Children up to 6 years of age - Use and dose must be determined by your doctor.
    • Older adults - At first, 25 mg at bedtime. Your doctor may increase your dose gradually as needed. However, the dose is usually not more than 100 mg a day.
• For syrup dosage form:
  • For depression:
    • Adults - At first, 25 mg two to four times a day. Your doctor may increase your dose gradually as needed.
    • Teenagers - At first, 10 mg three times a day, and 20 mg at bedtime. Your doctor may increase your dose gradually as needed. However, the dose is usually not more than 100 mg a day.
    • Children 6 to 12 years of age - 10 to 30 mg a day.
    • Children up to 6 years of age - Use and dose must be determined by your doctor.
    • Older adults - At first, 10 mg three times a day, and 20 mg at bedtime. Your doctor may increase your dose gradually as needed. However, the dose is usually not more than 100 mg a day.
• For injection dosage form:
  • For depression:
    • Adults - 20 to 30 mg four times a day, injected into a muscle.
    • Children up to 12 years of age - Use and dose must be determined by your doctor.

For amoxapine
• For tablet dosage form:
  • For depression:
    • Adults - At first, 50 milligrams (mg) two to three times a day. Your doctor may increase your dose gradually as needed.
    • Children up to 16 years of age - Use and dose must be determined by your doctor.
    • Older adults - At first, 25 mg two to three times a day. Your doctor may increase your dose gradually as needed.

For clomipramine
• For capsule or tablet dosage forms:
  • For obsessive-compulsive disorders:
    • Adults - At first, 25 milligrams (mg) once a day. Your doctor may increase your dose gradually as needed. However, the dose is usually not more than 250 mg a day, unless you are in the hospital. Some hospitalized patients may need higher doses.
    • Teenagers and children 10 years of age and over - At first, 25 mg once a day. Your doctor may increase your dose gradually as needed. However, the dose is usually not more than 200 mg a day.
    • Children up to 10 years of age - Use and dose must be determined by your doctor.
    • Older adults - At first, 20 to 30 mg a day. Your doctor may increase your dose gradually as needed.

For desipramine
• For tablet dosage form:
  • For depression:
    • Adults - 100 to 200 milligrams (mg) a day. Your doctor may increase your dose gradually as needed. However, the dose is usually not more than 300 mg a day.
    • Teenagers - 25 to 50 mg a day. Your doctor may increase your dose gradually as needed. However, the dose is usually not more than 100 mg a day.
    • Children 6 to 12 years of age - 10 to 30 mg a day.
    • Older adults - 25 to 50 mg a day. Your doctor may increase your dose gradually as needed. However, the dose is usually not more than 150 mg a day.

For doxepin
• For capsule or solution dosage forms:
  • For depression:
    • Adults - At first, 25 milligrams (mg) three times a day. Your doctor may increase your dose gradually as needed. However, the dose is usually not more than 150 mg a day, unless you are in the hospital. Some hospitalized patients may need higher doses.
    • Children up to 12 years of age - Use and dose must be determined by your doctor.
    • Older adults - At first, 25 to 50 mg a day. Your doctor may increase your dose gradually as needed.

For imipramine
• For tablet dosage form:
  • For depression:
    • Adults - 25 to 50 milligrams (mg) three to four times a day. Your doctor may increase your dose gradually as needed. However, the dose is usually not more than 200 mg a day, unless you are in the hospital. Some hospitalized patients may need higher doses.
    • Adolescents - 25 to 50 mg a day. Your doctor may increase your dose gradually as needed. However, the dose is usually not more than 100 mg a day.
    • Children 6 to 12 years of age - 10 to 30 mg a day.
    • Children up to 6 years of age - Use and dose must be determined by your doctor.
    • Older adults - At first, 25 mg at bedtime. Your doctor may increase your dose gradually as needed. However, the dose is usually not more than 100 mg a day.
  • For bedwetting:
    • Children - 25 mg once a day, taken one hour before bedtime. Your doctor may increase the dose as needed, based on the child's age.
• For capsule dosage form:
  • For depression:
    • Adults - At first, 75 mg a day taken at bedtime. Your doctor may increase your dose gradually as needed. However, the dose is usually not more than 200 mg a day, unless you are in the hospital. Some hospitalized patients may need higher doses.
    • Children up to 12 years of age - Use and dose must be determined by your doctor.
• For injection dosage form:
  • For depression:
    • Adults - Dose must be determined by your doctor. It is injected into a muscle. The dose is usually not more than 300 mg a day.
    • Children up to 12 years of age - Use and dose must be determined by your doctor.

For nortriptyline
• For capsule or solution dosage forms:
  • For depression:
    • Adults - 25 milligrams (mg) three to four times a day. Your doctor may increase your dose gradually as needed. However, the dose is usually not more than 150 mg a day.
    • Teenagers - 25 to 50 mg a day. Your doctor may increase your dose gradually as needed.
    • Children 6 to 12 years of age - 10 to 20 mg a day.
    • Older adults - 30 to 50 mg a day. Your doctor may increase your dose gradually as needed.

For protriptyline
• For tablet dosage form:
  • For depression:
    • Adults - At first, 5 to 10 milligrams (mg) three to four times a day. Your doctor may increase your dose gradually as needed. However, the dose is usually not more than 60 mg a day.
    • Teenagers - At first, 5 mg three times a day. Your doctor may increase your dose gradually as needed.
    • Children up to 12 years of age - Use and dose must be determined by your doctor.
    • Older adults - At first, 5 mg three times a day. Your doctor may increase your dose gradually as needed.

For trimipramine
• For capsule or tablet dosage forms:
  • For depression:
    • Adults - At first, 75 milligrams (mg) a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 200 mg a day, unless you are hospitalized. Some hospitalized patients may need higher doses.
    • Teenagers - At first, 50 mg a day. Your doctor may increase your dose gradually as needed. However, the dose is usually not more than 100 mg a day.
    • Children up to 12 years of age - Use and dose must be determined by your doctor.
    • Older adults - At first, 50 mg a day. Your doctor may increase your dose gradually as needed. However, the dose is usually not more than 100 mg a day.

Missed dose - If you miss a dose of this medicine and your dosing schedule is:

• One dose a day at bedtime - Do not take the missed dose in the morning since it may cause disturbing side effects during waking hours. Instead, check with your doctor.
• More than one dose a day - Take the missed dose as soon as possible. However, if it is almost time for your next dose, skip the missed dose, and go back to your regular dosing schedule. Do not double doses.

If you have any questions about this, check with your doctor.

Storage - To store this medicine:

• Keep out of the reach of children. Overdose of this medicine is very dangerous in young children.
• Store away from heat and direct light.
• Do not store the tablet or capsule form of this medicine in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
• Keep the liquid form of this medicine from freezing.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.