Amoxapine Is a Tricyclic Antidepressant Used to Treat Depression

Amoxapine is a prescription tricyclic antidepressant (TCA) used to treat depression, including depression with anxiety, agitation, or psychotic features. It belongs to the dibenzoxazepine class and works by blocking norepinephrine reuptake and dopamine receptors in the brain.

If you've been prescribed Amoxapine — or your doctor is considering it — this guide covers everything you need to know: what it's used for, how to take it, who should avoid it, and what it costs in 2026.

What Is Amoxapine?

Here are the key facts:

• Generic name: Amoxapine
• Brand name: Asendin (discontinued in the US)
• Drug class: Tricyclic antidepressant (TCA), second-generation dibenzoxazepine
• Manufacturer: Teva Pharmaceuticals (generic); brand originally by Lederle/Wyeth
• Available forms: Oral tablets — 25 mg, 50 mg, 100 mg, 150 mg
• Controlled substance: No — Amoxapine is not a controlled substance
• Generic available: Yes

Amoxapine is notable among TCAs because it also blocks dopamine D2 receptors, giving it mild antipsychotic-like properties. It's the N-demethylated metabolite of Loxapine, an antipsychotic — which explains its unique pharmacological profile.

What Is Amoxapine Used For?

FDA-Approved Uses

• Major depressive disorder — Including treatment-resistant depression
• Depression with anxiety
• Depression with agitation
• Depression with psychotic features — Amoxapine's dopamine-blocking properties make it particularly useful here
• Neurotic depression
• Recurrent depression

Off-Label Uses

Some doctors prescribe Amoxapine off-label for:

• Neuropathic pain
• Chemotherapy-induced diarrhea (with Irinotecan)

There's also research interest in Amoxapine for Alzheimer's disease due to its effect on amyloid-beta protein through 5-HT6 receptor activity, though this is still investigational.

Amoxapine is typically prescribed after first-line antidepressants (SSRIs and SNRIs) haven't provided adequate relief. Learn more about how Amoxapine works in our detailed explainer.

How Is Amoxapine Taken?

Amoxapine is taken by mouth, usually as follows:

• Starting dose: 50 mg two to three times daily, or 100 mg once daily at bedtime
• Typical maintenance dose: 200–300 mg per day
• Maximum dose: 400 mg/day for outpatients; 600 mg/day in hospital settings
• Timing: Can be taken once daily at bedtime (if dose is 300 mg or less) or in divided doses throughout the day
• With food: Can be taken with or without food

Important: Do not stop Amoxapine abruptly. Suddenly stopping can cause withdrawal symptoms including nausea, headache, and irritability. Your doctor will taper your dose gradually when it's time to discontinue.

Your doctor will typically start at a low dose and increase over 1–2 weeks based on your response and tolerance. Doses above 300 mg/day should be divided into multiple daily doses.

Who Should Not Take Amoxapine?

Amoxapine is not appropriate for everyone. You should not take it if you:

• Are allergic to Amoxapine or other dibenzoxazepine compounds
• Have taken an MAO inhibitor within the last 14 days (risk of serotonin syndrome and hypertensive crisis)
• Are in the acute recovery phase after a heart attack
• Are taking Linezolid or IV Methylene Blue

Use caution if you have a history of seizures, heart problems, liver disease, glaucoma, or urinary retention. Amoxapine is Pregnancy Category C — it should only be used during pregnancy if the benefits clearly outweigh the risks. It's also excreted in breast milk.

For a full list of medications to avoid, see our guide to Amoxapine drug interactions.

What Are the Side Effects?

Common side effects include drowsiness, dry mouth, constipation, blurred vision, dizziness, and weight gain. Most of these improve over the first few weeks.

Serious side effects are less common but include tardive dyskinesia (involuntary movements), seizures, cardiac arrhythmias, and neuroleptic malignant syndrome. Amoxapine also carries an FDA black box warning about increased risk of suicidal thinking in people under 25.

Read our complete guide to Amoxapine side effects for details on what to watch for and when to call your doctor.

How Much Does Amoxapine Cost?

Since the brand name Asendin is discontinued, only generic Amoxapine is available in the US. Here's what you can expect to pay:

• Retail cash price: $30–$80 for 30 tablets, depending on the strength
• With discount coupons: As low as $11–$19 for 30 tablets of 100 mg
• Insurance: Generally covered as a Tier 2 generic. Some plans may require prior authorization or step therapy through SSRIs/SNRIs first.

There's no active manufacturer savings program since the brand is discontinued, but third-party resources like NeedyMeds and NiceRx may help eligible patients. For a full breakdown of savings options, check our guide on how to save money on Amoxapine.

Current Availability

Amoxapine is currently in an active shortage. Teva Pharmaceuticals is the sole US manufacturer, and supply has been inconsistent since August 2024. If your pharmacy doesn't have it, use Medfinder to check other pharmacies in your area.

Final Thoughts

Amoxapine is a well-established antidepressant that fills an important niche — particularly for depression with psychotic features or when newer medications haven't worked. Its unique dopamine-blocking properties set it apart from other TCAs, though they also bring distinct risks like tardive dyskinesia that require monitoring.

If you're considering Amoxapine, work closely with your doctor to understand whether it's the right fit for your situation. And if you're already taking it, stay proactive about managing the current supply challenges — Medfinder can help you find a prescriber and locate pharmacies with stock.