Does doxepin become more sedating the LOWER the dose is?

[mikl_pls]

It's the time of year again when I start having trouble sleeping, and I've tried numerous meds for insomnia (and at the same time I have hypersomnia too... go figure...). My insurance doesn't cover Silenor, brand-named doxepin in 3 mg and 6 mg micro-doses, so my pdoc gave me Sinequan (doxepin) 50 mg. I've tried doxepin before, but at 75 mg, which for some stupid reason my insurance treats as tier IV non-preferred brand name, but all the other doses my insurance is like "oh you're cool, that's tier II..." Anyway...

So the doxepin 50 mg worked extremely well the first night, and the first night only. After that, I have trouble initiating and maintaining sleep, so I get anywhere from 3-4 hours of fragmented sleep according to my Fitbit. Then I'm tired all day, but I can't really nap because of my stimulant, which is nice because it keeps me going and whatnot, but I don't feel like keeping going because I'm exhausted. So I tried taking two doxepin one night for 100 mg and I actually felt a little stimulated and got about 2 hours of sleep.

So I have two questions for those who have taken doxepin:

1. If 50 mg isn't working for sleep, do I need to go lower in dose? Like 25 mg or even 10 mg?
2. Does doxepin actually become stimulating in higher doses like some of the TCAs?

Thanks in advance for any input!

[CrazyRedhead]

2 hours ago, mikl_pls said:

  So I have two questions for those who have taken doxepin:

1. If 50 mg isn't working for sleep, do I need to go lower in dose? Like 25 mg or even 10 mg?
2. Does doxepin actually become stimulating in higher doses like some of the TCAs?

Thanks in advance for any input!

I have a little experience with doxepin.....Tried it a few years ago, only for sleep purposes.

My pdoc claimed it was more sedating at lower doses, so I started off at only 10mg........

10mg worked pretty well for about 6 months and then that dose pooped out on me, so we tried going up to 25mg......25mg made my insomnia even worse, and that was when I gave up on doxepin.

So, for me personally at least, doxepin was better for sleep at a lower dose.....Maybe you could ask your pdoc about trying 10mg,  just to see if it works better for you.

Edited February 28, 2018 by CrazyRedhead

[notloki]

Doxepin is a big antihistamine, a powerful one.This is why it is so sedating. Many antihistamines are supposed to get less sedating the higher the dose. I took doxepin for several years as my primary antidepressant at doses from 25 mg to 300 mg. It got more sedating as the dose went up to about 100 mg then it leveled out.