Does doxepin (a tricyclic antidepressant) affect serum sodium levels?

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Last updated: April 25, 2025View editorial policy

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From the Research

Doxepin can potentially impact sodium levels in your blood, though this is not a common side effect, and the most recent evidence suggests that tricyclic antidepressants like doxepin may cause hyponatremia, particularly in older adults or those taking other medications that affect sodium balance 1.

Key Points to Consider

  • The risk of hyponatremia increases with higher doses and longer treatment duration of doxepin.
  • Doxepin can enhance the action of antidiuretic hormone (ADH), leading to increased water retention and dilution of sodium in the bloodstream.
  • Symptoms of low sodium may include headache, confusion, weakness, nausea, and in severe cases, seizures or coma.
  • If you're taking doxepin, especially at higher doses or if you're elderly, your healthcare provider may monitor your sodium levels periodically through blood tests.

Monitoring and Treatment

  • You should contact your doctor if you experience unusual symptoms like confusion, severe headache, or significant weakness while taking this medication.
  • Treatment for hyponatremia caused by doxepin may involve discontinuing the medication, fluid restriction, or the use of vasopressin receptor antagonists, such as tolvaptan, to correct sodium levels 2.
  • It's essential to note that the management of hyponatremia should be individualized, and the treatment approach may vary depending on the underlying cause and severity of the condition 3.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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