Depression medication

[Batgirl]

I have taken Dothiepin (Dosulepin) at a maintenance dose of 75mg for many years, but am concerned about the long-term effects, especially cardiovascular. I was put on this by my GP after not getting on with SSRIs because they make me feel too 'wired' & I do not sleep. I've tried many different ones but they all affect me in the same way. The Dothiepin ensures I get a decent night's sleep & keeps my anxiety levels under control. I am happy with this as I feel stable & my depression is well-controlled. However in the Winter I do tend to go downhill due to lower light levels, despite using a lightbox. I also feel particularly 'doped up' first thing in the morning & find it hard to wake up & feel overcome with lethargy. I feel that the Dothiepin contributes to this & wonder if I should change it in the Winter to something less sedating but I don't know what & don't want to use SSRIs. I wondered if Lofepramine would be suitable instead - please can you advise?

[Dr Gary Jackson]

You really do need to discuss this with your prescribing doctor. There are other drugs, eg. mirtazapine, which may suit you. You really don't have to worry about the cardiovascular effects of a lowish dose of Dothiepin - your dose is fairly low. You could ask for and ECG for reassurance.
Dr Jackson