Doxepin: Uses, Alternatives, and What You Need to Know

When you hear doxepin, a tricyclic antidepressant originally developed for depression but now widely used for sleep and anxiety. Also known as Sinequan, it’s one of the older antidepressants still in use today because it works differently than newer SSRIs—especially when it comes to sleep. Unlike drugs that just boost serotonin, doxepin blocks histamine and norepinephrine too, which is why even low doses (3mg to 6mg) can help you fall asleep faster and stay asleep longer.

It’s not just a sleep pill. Doctors still prescribe higher doses (25mg to 150mg) for major depression and chronic anxiety, especially when other meds haven’t worked. But it’s not for everyone. People with glaucoma, heart rhythm issues, or a history of seizures are usually told to avoid it. And because it stays in your system longer than most sleep aids, you might feel groggy the next morning—something you won’t see with zolpidem or trazodone. If you’ve tried melatonin, ramelteon, or even low-dose mirtazapine for sleep and still wake up at 3 a.m., doxepin might be the missing piece. But if you’ve had bad reactions to amitriptyline or nortriptyline, you’re likely to react the same way here—they’re all in the same family.

What you’ll find below is a collection of real comparisons: how doxepin stacks up against other sleep and mood meds, what people actually experience when they stop taking it, and which alternatives work better for specific cases. You’ll see side-by-side breakdowns of tricyclics like amitriptyline versus newer options like trazodone or low-dose SSRIs for insomnia. There are also posts on managing withdrawal symptoms, how doxepin affects weight, and why some doctors now prefer it over benzodiazepines for long-term anxiety. This isn’t theoretical. These are real patient experiences, doctor insights, and direct comparisons from people who’ve tried multiple options and found what actually works.

Whether you’re considering doxepin for the first time, struggling with withdrawal, or looking for something gentler than sleeping pills, the posts here give you the no-fluff facts. No marketing. No hype. Just what works, what doesn’t, and why.