Doxepin carries a black box warning given its potential to increase the risk of suicide in children and young adults who have a history of depression or other mental illness. Doxepin has many drug interactions with other medications, and therefore it is important for any person taking doxepin to inform their doctor or pharmacist about other medications they are taking. Lastly, the dose of doxepin is often started low and increased slowly, due to its many side effects, and the medication should also not be stopped abruptly. Doxepin requires a weening off of the medication to avoid withdrawal symptoms, including nausea, vomiting, diarrhea, headache, sleeping problems, dizziness, fatigue and irritability.
While doxepin is very useful for the treatment of hives and itching, it should be taken with caution and under the careful supervision of a physician.
Fleischer AB. Histamine H1 Antagonists. N Engl J Med. 1994; 331:1019-1020.
DuBuske LM. Clinical Comparison of Histamine H1-Receptor Antagonist Drugs. J Allergy Clin Immunol. 1996;98:S307-18.
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