Silenor (doxepin)

Anyone out there using, or has used, Silenor? If so, at which dose? Did it help at all with sleep onset or only sleep maintenance? Any hangover? Does one really have to not eat 3 hours prior to taking it? Any anti-cholinergic side effects, such as dry mouth, dry eyes, etc.? How about any RLS? Thanks!

BUMP. Since Silenor is believed to work on histamines, I suspect that it may simply be Unisom on steroids (figuratively speaking, of course). It is available via Rx but is not listed as a controlled drug like benzos etc.

Not to hijack this thread, but a couple of people PM’ed me and asked what I knew about Unisom/Sominex, so I thought I’d append this brief history of my experience:

I tried Unisom/Sominex for a month or two a little over a year ago. It did work some of the time, but I found it unreliable. Doxylamine is the active ingredient, virtually the same as Diphenydramamine which is found in most OTC allergy antihistamines (and a lot cheaper than Sominex/Unisom, BTW). There were two possible related side affects. As I said, I couldn't consistently count on it to work, plus at about that time I started having inner ear inflammation, possibly related to its usage. I was using Swift FX nasal pillows at the time and my sleep doctor changed me over to the Wisp system and told me cease taking Unisom, antihistamines etc. Secondly, it seemed to cause my prostate gland to flare up a day or two after I'd taken it... obviously that isn't an issue for women.

Notably, Dramamine, an OTC drug, is also related to both the two chemicals I mentioned above and works by somehow affecting the inner ear to ease motion sickness symptoms. Hence, my suspicion of these chemicals and my ear problems which are now 99 percent gone.

SleepingUgly wrote:Anyone out there using, or has used, Silenor? If so, at which dose? Did it help at all with sleep onset or only sleep maintenance? Any hangover? Does one really have to not eat 3 hours prior to taking it? Any anti-cholinergic side effects, such as dry mouth, dry eyes, etc.? How about any RLS? Thanks!

I'm not going to be much help, but I did try Doxepin about a year ago. I stopped taking it really quickly but I don't remember why. I've been on and off so many meds for migraines that I don't remember much about it. I didn't experience dry mouth or eyes and didn't have RLS, if that helps. I take ambien occasionally, which I found much better.

I took Doxepin for sleep as part of my psych med cocktail when Remeron stopped being effective as a sleep aid. It mostly helped but caused tinnitus along with the Wellbutrin I was on which still is an issue even though I have been off meds since June 2010.

I am not sure what other issues it caused since it was hard to separate them out from the other meds. But I am positive it contributed to the tinnitus.

Good luck with your decision regarding whether or not to take it.

49er

Silenor is 3 or 6 mgs of doxepin only, and no more. It seems Silenor's patent is partly (solely?) based on the effects on sleep maintenance insomnia at this very low doses, without next day sedation IF TAKEN 3 HOURS AFTER A MEAL. If taken with food (or is it just WITH HIGH FAT meals?), it delays peak concentration from 3.5 hours to 6.5 hours, which is so close to the end of the night that it can cause next day sedation. I know good sleep hygiene would say don't eat 3 hours before bed anyway, but haven't I suffered enough???? Seriously, I don't think I could stick to that.

I tried the 3 mg dosage, provided as a manufacturer's sample. For me, not surprisingly, I found the effect to be similar to that of Benadryl - promoting sleep onset, but resulting in non-restorative sleep with significant drug hangover.

Jay Aitchsee wrote:I tried the 3 mg dosage, provided as a manufacturer's sample. For me, not surprisingly, I found the effect to be similar to that of Benadryl - promoting sleep onset, but resulting in non-restorative sleep with significant drug hangover.

How long did you take it after you ate? There seems to be a serious food effect with this medication.

SleepingUgly wrote:
How long did you take it after you ate? There seems to be a serious food effect with this medication.

The instructions that came with my sample were simply "Silenor should be taken within 30 minutes of bedtime. Be sure that you are able to devote 7 to 8 hours to sleep before being active again." No mention of meals. However, I usually do not eat after 6pm and usually go to bed around 11 pm which I'm sure was the case when I took the drug.
The thing that got me is that the cost of 30 10 mg generic doxepin tabs at Walmart is $7 while 30 3mg Silenor tabs is $188. What a rip.

In (much) larger doses, doxepin is used as an antidepressant. I think it probably got started as a sleep aid due to its sedative properties. So, the manufacturer probably got wise to a new marketing strategy, and developed this tiny dose for those of us who need it. When pharmaceutical companies do "fed/fasted" studies to see how much difference there is when folks take their oral drugs in fed or fasted states, they usually use a high-fat meal to test the fed state. Not working there now, but I worked in the pharmaceutical industry for 24 years, in new drug development.

I believe that I have taken a larger dose of doxepin, back in the '80's. With that dose, I got the whole boatload of side effects. The worst was the double vision. I don't think that the 3-6 mg doses have much chance of having that effect.

No history with the one you are talking about - but I have been using clonazepam 0.5mg (Klonopin) for about a week now. I suffer from REM Sleep Behavior Disorder or RSB Disorder. So far so good for me. I take it 1/2 hour before bed with no concerns for food. I have had no issues since starting this. I have had RSB Disorder for ~30 years from from I can tell, but just diagnosed with it last week.

howkim wrote:In (much) larger doses, doxepin is used as an antidepressant. I think it probably got started as a sleep aid due to its sedative properties. So, the manufacturer probably got wise to a new marketing strategy, and developed this tiny dose for those of us who need it.

The 60's antidepressant Trazadone is another example of this corporate 'rebranding' motive. For occasional sleeplessness they are probably okay, or so my GP says, however I'd use them sparingly, just to be on the safe side.