Drug interactions-  summary

Barbiturates reduce antidepressant effect of dosulepin

Raised erun concentration with with methylphenidate .

Cigarette smoking enhances metabolism.

Increased risk of ventricular arrhthymias when used with drugs that prolong QT intervals

Should not be given concurrently or within 14 days of stopping MAOIs .

Potentiates catecholamine, sympathomimetics , narcotics, and alcohol

Reduce hypotensive  activity of bethanidine , guanethidine 

Depression

Cholestic jaundice,    sexual dysfunction,   exacerbation of psychotic manifestation,

cardiac arrhthymias,   hypotension,  dry mouth,  constipation,  disturbance of accomodation,

tachycardia,  postural hypotension, drowsiness, tremors, and skin rash

Withdrawal symptoms with abrupt cessation, insomnia irrirability, and excessive sweating

Bone marrow  depresson, cardiac arrhythmias, and agranulocytosis.

Reports of ventricular fibrilation and renal failure

Hypersensitivity, recent MI , neonate heart block, cardiac arrhythmias, mania,

alcohol, other CNS depressants,

Severe liver disease, prostate disease, children

Special Precautions-

Epilepsy, hypotension, glaucoma, urinary retension,  gradual withdrawal,

Pregnancy, Lactation, elderly

Date of Approval    2010

  For the treatment of neuropathic pain

Indication-

Depression

Dosage-

Adult- initially 25mg tid, gradually increased to 50mg tid if necessary,
alternately as a single dose at night.
Upto 225mg/day may be used in severe depressin.

Elderly- initially 50- 75mg daily

Contraindicated for use during pregnancy