Novel therapeutic usage of low-dose doxepin hydrochloride

Low-dose doxepin hydrochloride (1, 3 and 6 mg) is a tricyclic antidepressant currently being investigated for the treatment of primary insomnia in adult and geriatric patients. Although it has been used at much higher doses to treat depression effectively for a number of decades, it offers a unique potency and selectivity for antagonizing the H1 (histamine) receptor at low doses. This mechanism of action may prove to be advantageous compared with other medications currently approved for the treatment of insomnia. This article reviews previous clinical studies using doxepin for insomnia and the recent clinical trial data, and briefly discusses other potential roles of this compound in clinical practice.