amoxapine

Adjunctive therapy • Brands: Asendin

Last reviewed: 2026-03-31

General information

Class: Adjunctive therapy
Common US brands: Asendin
Typical dose range: Label dosing is individualized. A common initiation is 50 mg two or three times daily with gradual increases based on response and tolerability (label).
Therapeutic drug monitoring not routinely recommended.
Last reviewed: 2026-03-31

Dosing & forms

Forms/strengths: Oral tablets (label): 25 mg, 50 mg, 100 mg, 150 mg.
Frequency: Label dosing is individualized. A common initiation is 50 mg two or three times daily with gradual increases based on response and tolerability (label).
Typical range: Label dosing is individualized. A common initiation is 50 mg two or three times daily with gradual increases based on response and tolerability (label).

Mechanism (brief)

Dibenzoxazepine antidepressant with norepinephrine/serotonin reuptake inhibition and clinically meaningful dopamine receptor blockade (EPS/TD risk).

Metabolism & Half‑life

Metabolism: CYP2D6
Half‑life: Single-dose mean 8 h

Therapeutic Drug Monitoring (TDM)

Recommended: No

View labelExact

Monitoring highlights

Movement-disorder screening for EPS (rigidity, tremor, akathisia) and abnormal movements concerning for tardive dyskinesia, especially during titration and at higher doses (label/clinical).
Seizure risk review (history, co-medications) and reassessment when dose escalation is considered (label/clinical).
Orthostatic vitals, falls risk, and anticholinergic burden (bowel and bladder symptoms, cognition), especially in older adults (clinical).
ECG planning in patients with cardiac history, older age, electrolyte disturbance risk, or multiple QT-active drugs (clinical).
Suicidality and mood switching surveillance early in treatment and after dose changes (label/clinical).

Sources

Amoxapine tablets prescribing information — DailyMed (2024)
Consensus Guidelines for Therapeutic Drug Monitoring in Neuropsychopharmacology: Update 2017 — Pharmacopsychiatry (2018)
APA Clinical Practice Guideline for the Treatment of Depression — American Psychiatric Association (2023)
CANMAT 2024 Clinical Guidelines for Major Depressive Disorder — Canadian Journal of Psychiatry (2024)

General information

Class: Adjunctive therapy

Common US brands: Asendin

Typical dose range: Label dosing is individualized. A common initiation is 50 mg two or three times daily with gradual increases based on response and tolerability (label).

Therapeutic drug monitoring not routinely recommended.

Last reviewed: 2026-03-31

Dosing & forms

Forms/strengths: Oral tablets (label): 25 mg, 50 mg, 100 mg, 150 mg.

Frequency: Label dosing is individualized. A common initiation is 50 mg two or three times daily with gradual increases based on response and tolerability (label).

Typical range: Label dosing is individualized. A common initiation is 50 mg two or three times daily with gradual increases based on response and tolerability (label).

Monitoring highlights

Movement-disorder screening for EPS (rigidity, tremor, akathisia) and abnormal movements concerning for tardive dyskinesia, especially during titration and at higher doses (label/clinical).

Seizure risk review (history, co-medications) and reassessment when dose escalation is considered (label/clinical).

Orthostatic vitals, falls risk, and anticholinergic burden (bowel and bladder symptoms, cognition), especially in older adults (clinical).

ECG planning in patients with cardiac history, older age, electrolyte disturbance risk, or multiple QT-active drugs (clinical).

Suicidality and mood switching surveillance early in treatment and after dose changes (label/clinical).