This sheet talks about exposure to doxepin during a pregnancy and while breastfeeding. This information should not take the place of medical care and advice from your healthcare provider.
What is doxepin?
Doxepin is a tricyclic antidepressant approved to treat alcoholism, anxiety, depression, and insomnia (difficulty sleeping). As a cream it is used for short term treatment of itchiness. Some brand names include Quitaxon®, Prudoxin®, Silenor®, Sinequan®, and Zonalon®. It is also marketed as a combination drug with levomenthol under the brand name Doxure®.
MotherToBaby has fact sheets on depression https://mothertobaby.org/fact-sheets/depression-pregnancy/pdf/, anxiety https://mothertobaby.org/fact-sheets/anxiety/pdf/ and alcohol https://mothertobaby.org/fact-sheets/alcohol-pregnancy/pdf/.
I take doxepin. Can it make it harder for me to get pregnant?
Studies have not yet been done to see if taking doxepin could make it harder to get pregnant.
I just found out that I am pregnant. Should I stop taking doxepin?
Talk with your healthcare providers before making any changes to how you take your medication(s). For some, the benefits of staying on this medication during pregnancy may outweigh the potential risks. If you plan to stop this medication, your healthcare provider might suggest that you gradually lower the dosage instead of stopping all at once. This is because some people can have withdrawal symptoms when they suddenly stop taking doxepin.
Does taking doxepin increase the chance for miscarriage?
Miscarriage can occur in any pregnancy. It is not known if doxepin increases the chance for miscarriage.
Does taking doxepin increase the chance of having a baby with a birth defect?
Every pregnancy starts out with a 3-5% chance of having a birth defect. This is called the background risk. It is not known if doxepin increases the chance of birth defects. Based on animal studies, doxepin is not likely to increase the chance for birth defects. This medication has not been well studied for use in humans. In a series looking at 8 human pregnancies, there were no birth defects reported.
Could taking doxepin cause other pregnancy complications?
It is not known if doxepin might cause other pregnancy complications.
I need to take doxepin throughout my pregnancy. Will it cause withdrawal symptoms in my baby after birth?
Withdrawal symptoms have been reported when different tricyclic antidepressants were used during pregnancy. Symptoms reported with other medications in this class of drugs are usually mild and may include: jitteriness, vomiting, crying, fussiness, altered sleep patterns, tremors, and/or difficulty with eating and regulating body temperature. In most cases these symptoms were mild and went away on their own within a week or two after birth.
Does taking doxepin in pregnancy cause long-term problems in behavior or learning for the baby?
It is not known if doxepin can cause long-term learning or behavior problems.
Can I breastfeed while taking doxepin?
Information about the use of doxepin while breastfeeding is limited. Doxepin passes into breast milk and may have negative effects on a nursing infant. Two case reports of respiratory depression (trouble breathing) have been reported in babies who were exposed to doxepin through breastmilk. If you suspect that the baby has trouble breathing, contact the child’s healthcare provider. Also watch baby for irritability, sedation (trouble waking up), constipation and appropriate weight gain. Babies that are younger than 10 weeks old may have a higher chance of negative side effects. Discuss this and all of your breastfeeding questions with your baby’s pediatrician and/or your healthcare provider.
I take doxepin. Can it make it harder for me to get my partner pregnant or increase the chance of birth defects?
It is not known if there are risks to a pregnancy when the father or sperm donor takes doxepin. In general, exposures that fathers and sperm donors have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/pdf/.
Please click here for references.
National Pregnancy Registry for Psychiatric Medications: There is a pregnancy registry for women who take psychiatric medications, such as doxepin. For more information you can look at their website: https://womensmentalhealth.org/research/pregnancyregistry/.
OTIS/MotherToBaby encourages inclusive and person-centered language. While our name still contains a reference to mothers, we are updating our resources with more inclusive terms. Use of the term mother or maternal refers to a person who is pregnant. Use of the term father or paternal refers to a person who contributes sperm.
