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(a mox' a peen)A small number of children, teenagers, and young adults (up to 24 years of age) who took antidepressants ('mood elevators') such as amoxapine during clinical studies became suicidal (thinking about harming or killing oneself or planning or trying to do so). Children, teenagers, and young adults who take antidepressants to treat depression or other mental illnesses may be more likely to become suicidal than children, teenagers, and young adults who do not take antidepressants to treat these conditions. However, experts are not sure about how great this risk is and how much it should be considered in deciding whether a child or teenager should take an antidepressant. Children younger than 18 years of age should not normally take amoxapine, but in some cases, a doctor may decide that amoxapine is the best medication to treat a child's condition. You should know that your mental health may change in unexpected ways when you take amoxapine or other antidepressants even if you are an adult over age 24. You may become suicidal, especially at the beginning of your treatment and any time that your dose is increased or decreased. You, your family, or your caregiver should call your doctor right away if you experience any of the following symptoms: new or worsening depression; thinking about harming or killing yourself, or planning or trying to do so; extreme worry; agitation; panic attacks; difficulty falling asleep or staying asleep; aggressive behavior; irritability; acting without thinking; severe restlessness; and frenzied abnormal excitement. Be sure that your family or caregiver knows which symptoms may be serious so they can call the doctor when you are unable to seek treatment on your own. Your healthcare provider will want to see you often while you are taking amoxapine, especially at the beginning of your treatment. Be sure to keep all appointments for office visits with your doctor. No matter your age, before you take an antidepressant, you, your parent, or your caregiver should talk to your doctor about the risks and benefits of treating your condition with an antidepressant or with other treatments. You should also talk about the risks and benefits of not treating your condition. You should know that having depression or another mental illness greatly increases the risk that you will become suicidal. This risk is higher if you or anyone in your family has or has ever had bipolar disorder (mood that changes from depressed to abnormally excited) or mania (frenzied, abnormally excited mood) or has thought about or attempted suicide. Talk to your doctor about your condition, symptoms, and personal and family medical history. You and your doctor will decide what type of treatment is right for you.
Before taking amoxapine,
- tell your doctor and pharmacist if you are allergic to amoxapine, doxepin (Sinequan), any other medications, or any of the inactive ingredients in amoxapine tablets. Ask your doctor or pharmacist for a list of the inactive ingredients.
- tell your doctor if you are taking a monoamine oxidase (MAO) inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate), or if you have stopped taking an MAO inhibitor within the past 14 days. Your doctor will probably tell you not to take amoxapine. If you stop taking amoxapine, you should wait at least 14 days before you start to take an MAO inhibitor.
- tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: anticoagulants (blood thinners) such as warfarin (Coumadin); antihistamines; cimetidine (Tagamet); flecainide (Tambocor); levodopa (Sinemet, Larodopa); lithium (Eskalith, Lithobid); medications for high blood pressure, seizures, Parkinson's disease, asthma, colds, or allergies; methylphenidate (Ritalin); muscle relaxants; propafenone (Rhythmol); quinidine; sedatives; selective serotonin reuptake inhibitors (SSRIs) such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil), and sertraline (Zoloft); sleeping pills; thyroid medications; and tranquilizers. Your doctor may need to change the doses of your medications or monitor you more carefully for side effects.
- tell your doctor if you are being treated with electroshock therapy (procedure in which small electric shocks are administered to the brain to treat certain mental illnesses) and if you have or have ever had a heart attack, glaucoma (an eye disease), an enlarged prostate (a male reproductive organ), difficulty urinating, seizures, an overactive thyroid gland, or liver, kidney, or heart disease.
- tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while taking amoxapine, call your doctor immediately.
- talk to your doctor about the risks and benefits of taking amoxapine if you are 65 years of age or older. Older adults should not usually take amoxapine because it is not as safe or effective as other medications that can be used to treat the same condition.
- if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking amoxapine.
- you should know that this medication may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you.
- remember that alcohol can add to the drowsiness caused by this medication.
- weakness or tiredness
- dry mouth
- skin more sensitive to sunlight than usual
- changes in appetite or weight
- difficulty urinating
- frequent urination
- blurred vision
- excessive sweating
- muscle stiffness
- fast or irregular heartbeat
- slow or difficult speech
- shuffling walk
- uncontrollable shaking or moving of a part of the body