Patient/caregiver was educated on the side-effects of using Dothiepin as follows:

  1. Vision changes: Dothiepin use can result in pupillary dilation and obstruction to the drainage of fluid (aqueous humor) inside the eye. This blockage of fluid in the eye can result in increase in the intraocular pressure, leading to glaucoma. Individuals with glaucoma can present with eye pain, headache, and blurred vision with haloes around light.
  2. Gastrointestinal side-effects: Dothiepin use can result in common general constitutional symptoms such as, nausea and vomiting. Taking dose of dothiepin with a glass of water, after having some food or a snack can help avoid having unpleasant gastrointestinal symptoms with the medication. Dothiepin can also induce extreme dry mouth and constipation. Sucking on a sugar free hard candy can help with symptomatic relief of dry mouth. Proper hydration measures and compliance with daily fluid intake recommendations can help with relief from constipation. If you experience any further bothersome constipation, report it to your physician for a recommendation on laxative/stool softener use. Observing compliance with fiber intake recommendations in the diet can also help with preventing episodes of constipation with the medication.
  3. Serotonin syndrome: Serotonin is one chemical in the brain, which in permissible amounts, is believed to reduce anxiety and promote happiness and well-being. Very excessive concentrations of serotonin in the brain can lead to serotonin syndrome. Individuals with serotonin syndrome can present with mania, excitement, hallucinations, agitation, insomnia, pounding heartbeat, very rapid heart rate, overactive reflexes, and diarrhea. Dothiepin use, especially along with a few other antidepressants, such as, citalopram, fluoxetine, and sertraline, can significantly increase the serotonin levels in the body and lead to development of serotonin syndrome. Report symptoms of serotonin syndrome to your physician promptly for any appropriate measures to be considered.