QUESTION:
Dear Dr. Heller,
My PCP just prescribed Doxepin to control itching. I swear that it made me extremely agitated. I had been agitated for two days and I had started it two days prior. When I stopped it, I found I was not agitated at all the next day. Then I took it again one night and I became extremely agitated the next day. Do you think there might be a connection? I am afraid to take it (he prescribed 30 with 3 refills) and I stopped itching (probably a food allergy, but PCP thought I was allergic to Wellbutrin as I had started it two weeks prior to the itching and couldn’t think of any strange foods I ate). But if itching comes back I am afraid to take it. What should I do? The Doxepin is taken one at night and then two Allegra in daytime (but I was only taking the Doxepin after the 1st day).
ANSWER:
Doxepin (Sinequan) and Elavil (amitryptilline) are very similar tricyclic antidepressants. A study published in 1986 showed that Elavil made borderlines paranoid, aggressive, and agitated (Garbutt, J; George, A: “Paradoxical Effects of Amitriptyline on Borderline Patients.” Am J Psychiatry 143:12 December 1986). I’ve had many patients tell me the same thing. There are many other antidepressants that can be taken instead.