Medicines

Doxepin Vs Xanax: Differences Similarities, Which is Stronger

What is Doxepin?

Doxepin is tricyclic antidepressant (TCA) used to treat anxiety or depression. It is also used to treat insomnia (trouble with sleeping). It works on the central nervous system (CNS) to increase levels of certain chemicals in the brain.

This medicine is available only with your doctor’s prescription.

This product is available in the following dosage forms:

  • Tablet
  • Capsule
  • Solution

What is Xanax?

Xanax is a brand of alprazolam, a medication used to relieve symptoms of anxiety, including anxiety caused by depression. It is also used to treat panic disorder in some patients.

Alprazolam is a benzodiazepine. Benzodiazepines belong to the group of medicines called central nervous system (CNS) depressants, which are medicines that slow down the nervous system.

This medicine is available only with your doctor’s prescription.

This product is available in the following dosage forms:

  • Tablet
  • Tablet, Disintegrating
  • Solution
  • Tablet, Extended Release

Differences

Active Ingredient:  Xanax contains alprazolam as the active ingredient which works by enhancing the activity of certain neurotransmitters in the brain. Doxepin on the other hand is a tricyclic antidepressant that works by inhibiting your brain’s reuptake of these neurotransmitters, increasing the amount of serotonin and norepinephrine that can circulate throughout your brain and body.

Control status: Doxepin is not a controlled substance but the United States government has classified benzodiazepines, including alprazolam, as Schedule IV controlled substances in the Controlled Substances Act because of their abuse potential. This classification makes it easier for the government to track the prescription and distribution of Xanax.

Onset of Action: Peak concentrations of doxepin are reached in approximately two hours. The antidepressant effect of doxepin may take several weeks to develop. The anti-anxiety effect of doxepin is usually apparent before an antidepressant effect occurs. Compared to other similar substances, alprazolam is known for its quick action. Its effects may be felt within 30 minutes and can last for around 6 hours. If taken in large doses, the depressant effects are stronger and may cause lapses in memory.

Treatment Duration: The Food and Drug Administration (FDA) has approved Xanax for very short-term treatment for most conditions. Eight weeks is the maximum amount of time they should be taken, specifically to treat panic disorder. Most physicians or therapists will prescribe Xanax for “as-needed” treatment. Long-term use of Xanax induces a true chemical dependence as well as psychological dependence. Sudden cessation after long-term use can lead to seizures that can be fatal. Death from accidental acute overdose is uncommon.

Studies have shown that the long-term management of chronic depression with doxepin is feasible, efficacious, and safe. Low-dose doxepin is also a safe drug for short term and long-term insomnia.

Similarities

Prescription Status: Both Doxepin and Xanax are prescription medicines, meaning they legally require a medical prescription to be dispensed. Doxepin and Xanax must be prescribed by a doctor and are not licensed for sale to the general public. A prescription medication is a licensed medicine that is regulated by law to necessitate a medical prescription before it can be obtained.

Uses: Doxepin and Xanax are both used in the management of symptoms of anxiety and depression. In addition, Doxepin and Xanax are both used for sleep. Doxepin is a safe, easy-to-use, and effective medication for treating insomnia. Doxepin and Xanax are both used for sleep. Studies show that it can improve general sleep quality and increase the total amount of time people with insomnia spend asleep each night.  Although Xanax is not designed as a sleep aid, one of its side effects is drowsiness, which can help insomnia sufferers feel more tired at night and achieve deeper sleep. The issue is that Xanax is not a long-term treatment for insomnia.

Side effects: Doxepin and Xanax share similar side effects which include:

  • changes in appetite
  • changes in sex drive or ability
  • constipation
  • difficulty concentrating
  • difficulty urinating
  • dizziness
  • dry mouth
  • headache
  • nausea
  • tiredness

Which is stronger?

Xanax and doxepin are not the same, each drug has its own benefits. In a study which compared both drugs, patients were treated with a flexible dose of 1.0-4.5 mg of alprazolam and 50-225 mg of doxepin per day. The mean final doses were 2.7 mg for alprazolam and 137.5 mg for doxepin. The results indicate that alprazolam and doxepin were equally efficacious in the management of primary unipolar depression

Can I use Doxepin and Xanax together?

No, using Xanax together with doxepin may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination.

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Dr. Oche Otorkpa PG Cert, MPH, PhD

Dr. Oche is a seasoned Public Health specialist who holds a post graduate certificate in Pharmacology and Therapeutics, an MPH, and a PhD both from Texila American University. He is a member of the International Society of Substance Use Professionals and a Fellow of the Royal Society for Public Health in the UK. He authored two books: "The Unseen Terrorist," published by AuthorHouse UK, and "The Night Before I Killed Addiction."
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