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Doxepin
Depletes
Prolonged use of Doxepin can impact 10 essential nutrients.
COQ10
Coenzyme Q10 (CoQ10), also known as ubiquinone, is a vital nutrient found in nearly every cell in the body. CoQ10 plays a key role in cellular energy production, acting within the mitochondria, the powerhouses of our cells. Research suggests a connection between mitochondrial dysfunction and depression, and this dysfunction might even be worsened by some antidepressant medications like amitriptyline. It found that tricyclic amines such as amitriptyline treatment in human cells decreased the levels of CoQ10. Supplementation with COQ10 could help improve overall cellular health and potentially alleviate symptoms associated with mitochondrial dysfunction in depression.
Replace with COQ 10 (as Ubiquinone) (50 mg)
Research: Moreno-Fernández AM, Cordero MD, Garrido-Maraver J, Alcocer-Gómez E, Casas-Barquero N, Carmona-López MI, Sánchez-Alcázar JA,...
Vitamin B3
Research on the connection between vitamin B3 (niacin) and depression is growing. Studies suggest that people who met the recommended dietary allowance (RDA) for niacin had a significantly lower risk of depression compared to those with lower intake. Vitamin B3 plays a role in converting food into energy, which is essential for brain function and overall well-being. Deficiencies can lead to fatigue and low mood. Some research suggests vitamin B3 might be involved in the production of neurotransmitters like serotonin, which plays a role in mood regulation. Deficiencies in some neurotransmitters are linked to depression. Supplementation with vitamin B3 may help support mood and protect against depression. 
Replace with Vitamin B3 (50% Niacin and 50% Niacinamide) (20 mg)
Research: J. Woo, et al. Nutrient intake and psychological health in an elderly Chinese population. Geriatric Psychiatry. Volume21,...
Vitamin B2
Vitamin B2 (Riboflavin) may play a role in mood regulation, particularly in older adults. Research has found an association between higher dietary intake of vitamin B2 and lower scores on a depression scale (Geriatric Depression Scale) in elderly individuals. Vitamin B2 converts food into energy, which is essential for all bodily functions, including brain function. Deficiencies can lead to fatigue and low mood. It is also involved in the production of neurotransmitters, the chemical messengers in the brain that influence mood. Deficiencies in some neurotransmitters are linked to depression. Supplementation with vitamin B2 may help support mood and protect against depression.
Replace with Vitamin B2 Riboflavin (10 mg)
Research: J. Woo, et al. Nutrient intake and psychological health in an elderly Chinese population. Geriatric Psychiatry. Volume21,...
Also Benefits From:
Magnesium
Magnesium is a mineral that plays a crucial role in many bodily functions, including muscle and nerve function, blood sugar control, and blood pressure regulation. Research suggests it may also play a part in mood regulation. Studies have found a link between low magnesium intake and depression, particularly in younger adults. Magnesium is involved in various processes that impact mood including neurotransmitter function, stress response, and sleep regulation. Maintaining adequate magnesium levels could be beneficial for mood regulation and reduce the risk of depression.
Research: Jacka FN, Maes M, Pasco JA, Williams LJ, Berk M. Nutrient intakes and the common mental disorders in women. J Affect Disord....
Selenium
Selenium is a mineral that has emerged as a potential player in mood regulation. Studies demonstrate a link between lower dietary selenium intake and an increased risk of depression. Researchers propose that selenium's role as an antioxidant and a building block for proteins involved in cellular balance (redox homeostasis) might be a reason for this connection. The antioxidant properties could be particularly relevant because chronic inflammation and oxidative stress are implicated in depression.
Research: Pasco JA, Jacka FN, Williams LJ, Evans-Cleverdon M, Brennan SL, Kotowicz MA, Nicholson GC, Ball MJ, Berk M. Dietary selenium...
Vitamin B1
Thiamine (vitamin B1), a water-soluble B vitamin essential for energy production and nervous system function, is emerging as a potential player in mood disorders. Beyond its role in energy production, thiamine seems to have a significant impact on the nervous system. Studies suggest it's involved in maintaining healthy neurons, their communication (neurotransmission), and overall nervous system balance (homeostasis). This involvement extends to mood, cognitive function, and even the development of neurodegenerative diseases. Given its crucial role in neurological health and energy production, supplementation is suggested to support mood and protect against depression.
Research: Duc HN, Oh H, Yoon IM, Kim MS. Association between levels of thiamine intake, diabetes, cardiovascular diseases and...
Vitamin B12
Vitamin B12, also known as cobalamin, is a crucial nutrient involved in various bodily functions. A deficiency in this nutrient can lead to neurological and psychiatric problems, including depression. Vitamin B12 is involved in the production of neurotransmitters which play a key role in regulating mood, sleep, and motivation. Insufficient levels of B12 can disrupt their production, leading to symptoms of depression like low mood, fatigue, and loss of interest in activities. A severe B12 deficiency can damage the myelin sheath, a protective layer around nerves. This damage can interfere with nerve signals, leading to symptoms like memory problems, anxiety, and depression.
Research: Syed EU, Wasay M, Awan S. Vitamin B12 supplementation in treating major depressive disorder: a randomized controlled trial....
Vitamin D3
Vitamin D is a fat-soluble vitamin known for promoting bone health and increasingly recognized for its potential role in various bodily functions. Studies suggest this nutrient may help improve symptoms of depression and anxiety. Research shows that vitamin D supplementation can reverse some of the behavioral changes caused by chronic stress, including anxiety and depression-like behaviors in animal models. This positive effect might be due to vitamin D's ability to reduce inflammation and oxidative stress in the brain, both of which are linked to depression. Additionally, some studies in humans show a connection between low vitamin D levels and depressive symptoms, with supplementation helping improve these symptoms.
Research: Mikola T, et al. The effect of vitamin D supplementation on depressive symptoms in adults: A systematic review and...
Vitamin K2 (Menaquinone-7)
Research demonstrates that vitamin D3 and K2 can provide greater benefit together. Vitamin D3 and K2 help move calcium into your bones, where it's most beneficial. This prevents calcium buildup in your arteries and blood vessels. Their combined action can boost bone health, promote cardiovascular health, and combat inflammation. Both vitamins show promise in regulating inflammation, a key factor in many health concerns. By collaborating, vitamin D3 and K2 offer a broader spectrum of benefits, potentially protecting against serious illnesses and promoting overall well-being.
Research: Kuang X, Liu C, Guo X, Li K, Deng Q, Li D. The combination effect of vitamin K and vitamin D on human bone quality: a...
Zinc
Zinc is a mineral that plays a role in the production of neurotransmitters, chemical messengers in the brain that influence mood. Zinc has antioxidant properties that help protect cells from damage caused by free radicals. Chronic inflammation and oxidative stress are implicated in depression, and zinc's antioxidant effects could be beneficial in this regard. Studies have found an inverse association between dietary zinc intake and depression. This means people with lower zinc intake seem to be more likely to experience depression.
Research: Li, Zongyao, et al. Association of total zinc, iron, copper and selenium intakes with depression in the US adults. Journal...
Health Impact
Doxepin-induced nutrient depletion can lead to a range of health problems
Statin-Related Muscle Pain & Fatigue
Randomized trials and meta-analyses in statin-treated patients have shown that CoQ10 depletion and/or low circulating levels are associated with muscle symptoms, while supplementation has produced mixed but suggestive improvements in statin-associated myalgia and muscle pain severity.
Research: Caso G et al. Effect of coenzyme Q10 on myopathic symptoms in patients treated with statins. Am J Cardiol....
Low Mitochondrial Energy & Antioxidant Defense
Mechanistic and clinical studies link lower CoQ10 status with impaired oxidative phosphorylation and higher markers of oxidative stress, particularly in tissues with high metabolic demand such as myocardium and skeletal muscle.
Research: Littarru GP, Tiano L. Clinical aspects of coenzyme Q10: cardiology and beyond. Antioxid Redox Signal....
Pellagra: Dermatitis, Diarrhea, Dementia
Historical and modern reviews consistently define pellagra as systemic disease due to marked niacin deficiency, characterized by the four Ds: dermatitis, diarrhea, dementia and death.
Research: Hegyi J et al. Pellagra: dermatitis, dementia, and diarrhea. Int J Dermatol. 2004;43(1):1-5.; Redzic S, Gupta M. Niacin...
Early Niacin Deficiency Symptoms
Case reports and nutrition texts note oral lesions and neurocognitive symptoms as early manifestations of niacin deficiency, especially in malnutrition, alcoholism and malabsorption syndromes.
Research: Cleveland Clinic. Pellagra: definition, symptoms and treatment. 2023.; Mengistu SB et al. Pellagra presenting with...
Cheilosis, Glossitis & Mouth Sores
Nutrition and dental literature consistently describe angular cheilitis, glossitis and stomatitis as classic manifestations of riboflavin deficiency, often coexisting with other B-vitamin deficits.
Research: Bačun B et al. Manifestations and treatment of hypovitaminosis in oral mucosa. Int J Environ Res Public Health....
Ocular Irritation & Anemia
Reviews note that riboflavin deficiency may present with ocular hyperemia and corneal neovascularization, along with hematologic and neurologic changes in severe or prolonged depletion.
Research: Northrop-Clewes CA, Thurnham DI. Biomarkers for the assessment of vitamin B2 status. Br J Nutr. 2012;108(S1):S17-S28.;...
Side Effects
Common side effects of Doxepin, some of which may be related to nutrient depletion
Review
Some common side effects of Doxepin, an antidepressant drug, include:

1. Drowsiness or sedation
2. Dizziness or lightheadedness
3. Dry mouth
4. Constipation
5. Blurred vision
6. Tremors or shaking
7. Weight gain
8. Difficulty urinating
9. Increased heart rate
10. Confusion or memory problems

These side effects may vary from person to person and it's important to consult a healthcare provider if any of these side effects become severe or bothersome.
Get Support
We've developed a formula to replenish the nutrients depleted by Doxepin.
Doxepin Support Formula

Amitriptyline Support

Once Daily Capsule

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Shop Third-Party Supplements
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Vitamin B2 Riboflavin
by Pure Encapsulations
Vitamin B2 Riboflavin
Pure Encapsulations' Vitamin B2 supplement provides 400 mg of riboflavin per capsule to support energy production, cellular function, and overall health, using hypoallergenic, high-quality ingredients.
Strength: 10 mg

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Vitamin B2 Riboflavin
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Vitamin B3 (50% Niacin and 50% Niacinamide)
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The Vitamin B3 supplement by Pure Encapsulations provides a high-quality, hypoallergenic source of niacin to support cardiovascular health, energy production, and overall well-being.
Strength: 20 mg

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COQ 10 (as Ubiquinone)
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COQ 10 (as Ubiquinone)
The CoQ10 supplement by Life Extension is a high-quality dietary supplement designed to support cellular energy production and antioxidant protection, utilizing a bioavailable form of Coenzyme Q10.
Strength: 50 mg

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COQ 10 (as Ubiquinone)
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