Can you take Doxepin with Lexapro? (3+ risks)

In this article, we will explore whether you can take Doxepin and Lexapro together. We will also discuss the mechanism of action, indications, related research findings, benefits, side effects, and precautions that should be taken while using the combination of Doxepin and Lexapro.

Can you take Doxepin with Lexapro?

Yes, you can take Doxepin with Lexapro, but only if prescribed by your healthcare provider. This combination, if necessary, should only be used in reduced doses, as using Doxepin with Lexapro may have a risk of causing serotonin syndrome.

Serotonin syndrome is a rare but life-threatening condition. However, not everyone taking the combination of Doxepin and Lexapro will experience this side effect.

Lexapro, also known as Escitalopram, is a selective serotonin reuptake inhibitor (SSRI) antidepressant that increases serotonin levels by blocking its reuptake in brain cells. Serotonin is a chemical neurotransmitter in the brain that regulates sleep, anxiety, appetite, and stress response (1).

Doxepin, on the other hand, is a tricyclic antidepressant (TCA) that increases the levels of two neurotransmitters, serotonin and norepinephrine in the brain.

Doxepin blocks certain receptors, such as adrenergic and muscarinic receptors, and affects sodium and potassium channels in the heart muscles. Additionally, Doxepin affects histamine receptors, which relieve itching (2).

What are the indications of Doxepin and Lexapro?

Lexapro is used to treat and manage major depressive and generalized anxiety disorders. Lexapro may also be prescribed for social anxiety disorder, obsessive-compulsive disorder, panic disorder, post-traumatic stress disorder, premenstrual dysphoric disorder, and menopausal symptoms (1).

Doxepin is approved by the FDA to treat major depressive disorder, it can also be used to treat insomnia, anxiety, pain, and itchy skin, and prevent migraines (2).

What does research suggest?

According to research studies, Doxepin and Lexapro can be used together in low doses; however, when used together in higher doses, this combination may cause some genetic changes to the blood cells (3).

It’s important to be vigilant when using Doxepin and Lexapro together because both of them affect serotonin. Taking multiple drugs that affect serotonin can increase the risk of a rare but serious condition called serotonin syndrome.

Selective serotonin reuptake inhibitors, such as Lexapro and tricyclic antidepressants, such as Doxepin, both affect serotonin levels and have the potential to cause serotonin syndrome.

Serotonin syndrome can be mild and of short duration, but a prolonged course, life-threatening complications, and death are possible. If serotonin syndrome is diagnosed and immediately treated, the patient may recover completely (4).

Serotonin syndrome can be serious, but severe cases are rare. Mild cases caused by medication side effects are usually not life-threatening and can often be managed by stopping or reducing the medication.

Additionally, the combination of Doxepin and Lexapro may cause irregular heart rhythm problems. It is best to avoid using concomitant medicines that affect serotonin or use them cautiously if they are necessary in some cases.

Your doctor will monitor you closely for symptoms of serotonin syndrome when prescribing or increasing the dosage. If serotonin syndrome occurs, the Doxepin and Lexapro combination should be stopped immediately, and medical care should be provided as needed (5).

What are the benefits of using Doxepin with Lexapro?

Using the combination of Doxepin and Lexapro may provide benefits to some patients who do not respond well to either of these medications individually.

Combining these two medications should only be done under the guidance and supervision of a healthcare professional, and it should only be considered when the potential benefits outweigh the risks.

Your doctor may recommend the Doxepin and Lexapro combination if taking just one antidepressant is effectively managing symptoms of depression or anxiety to enhance the antidepressant effects.

Doxepin is also used to treat insomnia; therefore, if you are experiencing sleep problems alongside depression or anxiety while taking Lexapro, your healthcare provider may prescribe the combination of Doxepin and Lexapro.

Never combine Doxepin and Lexapro without your healthcare provider’s guidance. They will assess your specific situation and tailor the treatment plan to your needs (6).

What are the side effects of taking Doxepin with Lexapro?

The side effects of taking doxepin with Lexapro may include:

• Nausea
• Vomiting
• Constipation or diarrhoea
• Dizziness
• Weight loss
• Dry mouth
• Sexual side effects
• Excessive sweating
• Fatigue
• Serotonin syndrome
• Irregular heart rhythms

If you experience any of these side effects and they worsen, please immediately report it to your healthcare provider. Serotonin syndrome is a major risk of Doxepin and Lexapro combination; therefore you must be vigilant and not miss your follow-up sessions with a doctor to avoid this risk (7,8).

What precautions you should take while using Doxepin with Lexapro?

The precautions you should take while using Doxepin with Lexapro may include:

• Tell your doctor if you are allergic to Doxepin or Lexapro
• Inform your doctor if you are taking any other medication or supplements
• Your doctor must be aware of your family or medical history before prescribing this combination.
• Tell your doctor if you are planning to become pregnant as Doxepin and Lexapro have sexual side effects.
• Doxepin and Lexapro combination can affect the heart’s electrical activity, therefore, it is necessary to monitor the heart with ECG tests.
• Electrolyte levels should be monitored while taking Doxepin and Lexapro combination.
• Elderly people over 65 years of age should not take Doxepin
• Avoid driving while using the combination of Doxepin and Lexapro, as it may cause drowsiness.
• If this combination of doxepin and Lexapro needs to be discontinued, it should only be gradually discontinued under the supervision of your doctor (7,8).

Conclusion

In my perspective, taking Doxepin with Lexapro is possible, but this combination should only be used when prescribed and carefully monitored by your doctor. Doxepin and Lexapro can be combined to enhance their effects in managing symptoms of depression, anxiety, and insomnia in some cases.

However, there is a risk of serotonin syndrome, heart rhythm issues, and other side effects while using this combination. Regular follow-up sessions are important in managing and minimizing the associated risks.

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