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Doxepin may not be the right choice for every patient. In such cases, it is important to discuss with a doctor potential doxepin alternatives.

Doxepin Alternatives

What are your options when it comes to alternatives for doxepin?

For Sleep and Insomnia

Many tricyclic antidepressants will help with insomnia. If doxepin is not a good choice, there is mirtazapine (Remeron); it works in much the same way as doxepin does. There are also other classes of medications that may be appropriate, such as melatonin agonists like ramelteon (Rozerem). 

The most common choices for insomnia, though, are non benzodiazepine hypnotics like zolpidem (Ambien) or zaleplon (Sonata). Each one has pros and cons but would be effective in replacing doxepin. 

For Itching

Traditional choices for treating an itch would include corticosteroids or antihistamines. One could also try calcineurin inhibitors like tacrolimus (Protopic).

For Anxiety

There are many medications available for the treatment of anxiety disorders, including SSRIs like Prozac. There are also other tricyclic antidepressants that will serve this purpose, such as amitriptyline (Elavil) or nortriptyline (Pamelor). 

For Pain

Antidepressants like doxepin are sometimes used as a tool in chronic pain management. However, there are plenty of choices—including other tricyclics like imipramine (Tofranil), desipramine (Norpramin), and nortriptyline (Pamelor)—that can help. 

Other classes of antidepressants can help, too, such as serotonin and norepinephrine reuptake inhibitors (SNRIs). Some examples of SNRIs include venlafaxine (Effexor XR) or duloxetine (Cymbalta). 

For Nerve Pain

SNRIs and tricyclics might help, such as desipramine (Norpramin) or duloxetine (Cymbalta).

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