Doxepin is a tricyclic antidepressant with a range of medical purposes. Like other antidepressants, doxepin is not listed as a controlled substance. However, its use may cause a risk of side effects and overdose, particularly if it is misused. Doxepin should only be used with a prescription and taken exactly as instructed.
- Doxepin is a tricyclic antidepressant used to treat various conditions, including depression, anxiety, and insomnia.
- Doxepin is not a controlled substance.
- Doxepin use can lead to side effects and a risk of overdose. It should be taken exactly as prescribed.
Is doxepin (Silenor) a controlled substance?
Doxepin is not a controlled substance.
Doxepin is a tricyclic antidepressant (TCA) prescribed to treat depression, anxiety, insomnia, and skin pruritus. [1]
Controlled substances are classed under five schedules, depending on the risk of harm and addiction, and whether they have approved medical uses. Medications under Schedule I have no medical use and high risks of addiction and harm, while those in Schedule V have approved medical uses and less risk.
Doxepin is not listed as a controlled substance, as it has approved medical purposes and has a low risk of addiction, abuse, or harm.
Why doxepin isn't controlled
Doxepin is not considered an addictive substance. Like other antidepressants, doxepin use does not lead to euphoric ‘highs’. [2] It is not commonly abused or misused and is unlikely to cause physical and psychological dependence, characteristic of addiction. However, prolonged doxepin use may cause withdrawal symptoms when the medication is stopped. [1]
Although doxepin abuse is not common, people with substance use issues may misuse doxepin alongside other substances to enhance desirable effects.
Because of its low risk of abuse, addiction, and harm, doxepin is not a controlled substance.
Comparison with controlled sleep medications and benzodiazepines
Doxepin is prescribed to treat depression. Other antidepressants can be used, including selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs). These antidepressants, like doxepin, are also not controlled substances. [3]
Doxepin can also be prescribed to treat anxiety disorders and sleep disorders. Other medications used to treat these conditions include sedatives such as benzodiazepines and sleeping pills like zolpidem. These medications are classed as Schedule IV controlled substances, as they have a risk of abuse and addiction. [4]
Although these medications can be effective treatments, their risks can make them unsuitable for long-term use or for those with a history of substance use issues. Doxepin may be more suitable as a long-term treatment.
Advantages for patients in recovery
Patients in recovery may require treatment for mood, anxiety, or sleep disorders, as these can be common issues associated with substance withdrawal and recovery. These individuals may not be able to safely use certain medications, such as those that carry a risk of addiction and dependence, as this may be detrimental to their recovery process.
As such, a medication with low abuse and low addiction risk can be the most suitable option. Doxepin can be a helpful medication in these circumstances, as it can be used to manage a range of symptoms with little risk. [2]
Considerations and safety: What this means for patients and providers
Although it is not a controlled substance, doxepin does carry certain risks, particularly if it is misused. Doxepin should only be taken when prescribed by a licensed physician and dispensed by a licensed pharmacist. Throughout treatment, the prescribing physician should conduct regular reviews to ensure the safety and effectiveness of the medication.Â
Doxepin can cause side effects, particularly at the start of a new treatment. Generally, these side effects are mild and transient, although in some cases, serious side effects can occur. It is important to report concerning or persistent side effects to the prescribing doctor, as a change of dosage or medication may be necessary. [1]
Taking more doxepin than prescribed can result in overdose, which can cause serious or even fatal effects. If a doxepin overdose is suspected, call 911 immediately.Â
