At 12:24 10/12/2005, you wrote:
>Hi gang
>Prothiaden. Dosulepin as now is. Just scanning thro NICE guideline on
>depression (well it's either do some work or amuse the in-laws!) and I
>see Dosulepin lumped in with Phenelzine, combined ads and Lithium
>augmentation as specialist mental health professional initiation only.
>What on earth has happened this old faithful which I used for years in
>many patients to apparently good effect, nice sleepy night time effect,
>less tricyclic hangover and dry mouth than Amitrip or Imip.
>NOTHING dramatic in the BNF about it.
>Does anyone know why NICE should be agin it for ordinary GP prescribing?
>
>Declan
Declan
Can't speak for why NICE says we should think twice about it, but I reduced
usage after Pringle and a group from his area showed in a BMJ article that
MI rates were higher on dosulepin than on other tricyclics - NOTHING TO DO
WITH OVERDOSAGE.
I dramatically reduced my prescribing after this. However it's hard to see
that it should be a GPSI or consultant drug, the risks were modest, just
larger than many other antidepressants.
http://www.clinicalanswers.nhs.uk/index.cfm?question=875 refers to the 2001
study, and now that I've found it does explain a little of the background
to the NICE decision.
Julian
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