Updated: January 25, 2026

What Is Doxepin? Uses, Dosage, and What You Need to Know in 2026

Author

Peter Daggett

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What Is Doxepin?
What Is Doxepin Used For?
Doxepin Dosage Forms and Strengths
How Do You Take Doxepin?
Is Doxepin a Controlled Substance?
How Much Does Doxepin Cost?
What Should I Know Before Starting Doxepin?

Doxepin is a tricyclic antidepressant used for depression, anxiety, insomnia, and skin conditions. Here's everything you need to know about it in 2026.

Doxepin is a prescription medication that has been treating depression, anxiety, and sleep disorders in the United States since 1969. Despite being over 50 years old, it remains widely prescribed — over 3 million prescriptions were filled in 2023 alone. Here's a comprehensive guide to what doxepin is, how it works, what it's used for, and what you need to know before taking it.

What Is Doxepin?

Doxepin is a tricyclic antidepressant (TCA) — a class of medications named for their three-ring chemical structure. It was originally developed as an antidepressant, but research revealed it has uniquely powerful antihistamine properties that make it valuable for insomnia and skin conditions as well.

Doxepin is available under several brand names depending on its form:

Silenor: 3 mg and 6 mg tablets FDA-approved specifically for insomnia (sleep maintenance)
Sinequan (discontinued): The original brand-name capsule and oral concentrate for depression and anxiety; now only available as generic
Zonalon / Prudoxin: 5% topical cream for itching associated with atopic dermatitis and lichen simplex chronicus

What Is Doxepin Used For?

The FDA has approved doxepin for the following indications:

Major depressive disorder (MDD): Oral capsules and solution at 75–150 mg/day (up to 300 mg/day in severe cases)
Anxiety disorders: Used alongside or as an alternative to other anxiolytics
Insomnia (sleep maintenance): Silenor 3–6 mg taken 30 minutes before bedtime; the only antidepressant with FDA approval for insomnia
Skin pruritus (topical): Doxepin cream applied to itchy skin areas from atopic dermatitis or lichen simplex chronicus

Doxepin is also used off-label for chronic urticaria (hives), neuropathic pain, migraine prevention, and some other conditions.

Doxepin Dosage Forms and Strengths

Doxepin is available in the following forms:

Oral capsules: 10 mg, 25 mg, 50 mg, 75 mg, 100 mg, and 150 mg (for depression/anxiety)
Oral concentrate solution: 10 mg/mL (for depression/anxiety — dilute before taking)
Film-coated tablets: 3 mg and 6 mg (Silenor — for insomnia only)
Topical cream: 5% (Zonalon/Prudoxin — for itchy skin conditions)

How Do You Take Doxepin?

How you take doxepin depends on what condition it's treating:

For depression/anxiety (capsules): Starting dose typically 25 mg three times daily or 75 mg once daily. Target dose 75–150 mg/day. Can be taken with or without food.
For insomnia (Silenor tablets): 6 mg once daily (3 mg for elderly); take within 30 minutes of bedtime; do NOT take within 3 hours of a meal; only take if you have 7–8 hours to sleep.
Oral concentrate: Mix with 120 mL of water, milk, or juice (not carbonated drinks). Measure with the calibrated dropper provided.

Is Doxepin a Controlled Substance?

No. Doxepin is not a controlled substance. Unlike benzodiazepines (e.g., lorazepam) or Z-drugs (zolpidem, eszopiclone) commonly prescribed for sleep, doxepin has no recognized abuse or dependence potential. This makes it a preferred option for providers who want to treat insomnia without prescribing a controlled medication, and it can be prescribed via telehealth without DEA restrictions.

How Much Does Doxepin Cost?

Generic doxepin capsules are among the most affordable prescription medications available. A 30-day supply of 10–25 mg capsules can cost as little as $7–$15 with a GoodRx or SingleCare coupon at most pharmacies. Higher doses cost slightly more. Brand-name Silenor tablets are significantly more expensive — $96+ without insurance — though generic doxepin tablets at the same dose are much cheaper.

See our full guide to saving money on doxepin in 2026 for all available savings options.

What Should I Know Before Starting Doxepin?

Tell your doctor before starting doxepin if you have:

History of bipolar disorder, mania, or psychosis
Heart disease, irregular heartbeat, or family history of QT prolongation
Narrow-angle glaucoma (untreated) — doxepin is contraindicated
Urinary retention or enlarged prostate
Recent MAOI use (must wait 14 days before starting doxepin)
Pregnancy, breastfeeding, or plans to become pregnant

For a complete overview of side effects and what to watch for, see our guide on doxepin side effects.

Frequently Asked Questions

Doxepin is FDA-approved for major depressive disorder (MDD), anxiety disorders, and insomnia characterized by difficulty staying asleep (as Silenor 3–6 mg tablets). The topical cream is approved for skin itching. It's also used off-label for chronic urticaria (hives), neuropathic pain, and migraine prevention.

Silenor is a brand-name version of doxepin specifically formulated as 3 mg and 6 mg tablets for insomnia. Generic doxepin tablets at the same doses are therapeutically equivalent to Silenor at a much lower cost. Doxepin is also available in higher doses (10–150 mg capsules) for depression and anxiety — these are different products used for different conditions.

For insomnia (Silenor, 3–6 mg), many patients notice improved sleep within the first few nights. For depression and anxiety, doxepin typically takes 2–4 weeks to reach its full antidepressant effect, though some patients notice improvement in mood, sleep, and anxiety sooner. Don't stop taking it early just because you don't feel better immediately.

Yes, doxepin can be taken long-term for both depression/anxiety and insomnia. The clinical trials for Silenor (insomnia) demonstrated efficacy for up to 3 months. For depression, it may be continued for 6–12 months or longer depending on your treatment response and history. Your doctor will guide the appropriate duration and any tapering schedule when stopping.

Doxepin requires caution in older adults. The Beers Criteria (guidelines for medications in elderly patients) recommends avoiding doxepin at higher doses due to anticholinergic effects and fall risk. However, low-dose doxepin (3 mg for insomnia in elderly patients) is generally considered acceptable. Your geriatrician or primary care doctor can advise on safety for your specific situation.

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