Tricyclic antidepressants in the treatment of peptic ulcer disease

Doxepin hydrochloride was given to 12 patients with duodenal ulcer and one patient with an anastomotic ulcer. The dose of doxepin hydrochloride was 100 mg at bedtime, except in patients receiving hemodialysis, where only 50 mg at bedtime was given. Eight patients, including the four receiving hemodialysis, has not responded to treatment after eight weeks of cimetidine and/or antacid therapy. All patients (except one where a minor erosion was left in the duodenum) responded, and healing of the ulcer was demonstrated by endoscopy after four to six weeks of treatment. In two patients the ulcer recurred in four to eight weeks after discontinuation of doxepin therapy; however, ulcers healed after four weeks when therapy was reintroduced. Five previously untreated patients with duodenal ulcer were also given the same treatment. Four healed six weeks after starting doxepin therapy. In one patient the dose of doxepin hydrochloride had to be raised to 150 mg for complete healing.