Adults: Initially 75 mg/day in divided doses or as a single dose at night, increasing to 150 mg/day. In certain circumstances, e.g. in hospital use or unresponsive patients, dosages up to 225 mg daily have been used.
Suggested regimens: 25 or 50 mg three times daily or, alternatively, 75 or 150 mg as a single dose at night. Should the regimen of 150 mg as a single night-time dose be adopted, it is better to give a smaller dose for the first few days.
Elderly: 50 to 75 mg daily initially. As with any antidepressant, the initial dose should be increased with caution under close supervision. Half the normal adult dose may be sufficient to produce a satisfactory clinical response.
Children: Not recommended.
These side-effects cease when treatment ceases. Alcohol should be avoided whilst taking dosulepin as it may increase some side-effects.
Whilst dosulepin is not addictive, it should not be stopped suddenly as there is a risk of initial withdrawal symptoms which may be mistaken for some of the original indications for the drug:
The sedative effects of other CNS depressants (benzodiazepines such as diazepam and lorazepam, sedative antihistamines, opiates, etc.) may be increased.
This drug should not be started within 2 weeks of stopping a monoamine oxidase inhibitor (MAOI) antidepressant, and should not be co-administered with any selective serotonin reuptake inhibitor (SSRI) antidepressant such as fluoxetine), or any medication which affects the electrical impulses to the heart (e.g. astemizole, halofantrine or terfenadine).
The drug is not recommended for use by children nor to be taken in combination with some other drugs, including herbal remedies.