Doxepin in a Single Bedtime Dose in Psychoneurotic Outpatients

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Abstract
Forty-one psychoneurotic outpatients with mixed anxiety/depression and resultant sleep disturbances were randomly assigned to receive either doxepin hydrochloride or a placebo at bedtime in a double-blind study for four weeks. Scales used were the Lipman-Rickels Scale, the Psychiatric Outpatient Mood Scale, the Hamilton Anxiety Scale, and the Finnerty-Goldberg Sleep Evaluation Scale. The results of this study indicated that doxepin, given at bedtime, is significantly more effective than a placebo in treating mixed anxiety/depression, as shown by all three psychiatric rating scales used and by overall evaluation, even when the improvement is controlled for pretreatment correlates of improvement. The prediction model indicated that subjects with higher occupational levels, more severe Hamilton mental rating, and less severe Hamilton behavior rating, were more likely to improve. Bedtime dosing seemed to accelerate the antidepressive effect of doxepin while yielding significant improvement in sleep patterns.