ABSTRACT
Oral doxepin is approved for treatment of depression and/or anxiety associated with different conditions, including alcoholism, organic disease and manic-depressive disorders and for treatment of insomnia characterized by difficulties with sleep maintenance. Patch testing to doxepin 5% cream was positive in all patients for whom that information was provided, but it is unknown whether doxepin itself had been patch tested. The FDA authors conclude that ACD to doxepin 5% cream is not uncommon. Six patients developed severe allergic contact dermatitis to doxepin 5% cream after using it for 2 weeks to 7 months. In the USA, 97 consecutive patients were routinely patch tested with doxepin 5% cream for various forms of dermatitis in the period November 1994 November 1995, half a year after it was approved by the FDA. Two patients appeared to have had, according to the authors, systemic contact dermatitis from oral administration of doxepin after topical sensitization.
