Psychopharmacology: low-dose doxepin for insomnia: practice question

A Psychiatry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Psychiatry · Psychopharmacology: low-dose doxepin for insomnia

Sample item

A 55-year-old woman falls asleep easily but wakes repeatedly at 3 am. A drug is chosen that acts mainly through histamine H1 blockade at very low doses and does not cause dependence. Which is it?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Low-dose doxepin

At doses of 3 to 6 mg, doxepin is a selective H1 antagonist that improves sleep maintenance without dependence. At antidepressant doses it also blocks other receptors, with more anticholinergic effects.

Option by option

  • A. Low-dose doxepin (correct)

    Correct. Low-dose doxepin acts by H1 blockade and helps sleep maintenance.

  • B. Lorazepam

    Lorazepam acts on GABA-A receptors and causes dependence.

  • C. Zolpidem

    Zolpidem acts on GABA-A receptors and carries a risk of complex sleep behaviours.

  • D. Temazepam

    Temazepam is a benzodiazepine that can lead to tolerance and dependence.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Psychiatry question

What is the answer to this Psychiatry question?

The best answer is A, Low-dose doxepin. At doses of 3 to 6 mg, doxepin is a selective H1 antagonist that improves sleep maintenance without dependence.

Why is "Lorazepam" not the answer?

Lorazepam acts on GABA-A receptors and causes dependence.

Why is "Zolpidem" not the answer?

Zolpidem acts on GABA-A receptors and carries a risk of complex sleep behaviours.

Why is "Temazepam" not the answer?

Temazepam is a benzodiazepine that can lead to tolerance and dependence.

What concept does this question test?

It tests Psychopharmacology: low-dose doxepin for insomnia in Psychiatry. At antidepressant doses it also blocks other receptors, with more anticholinergic effects.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Psychopharmacology: low-dose doxepin for insomnia?

Learn each diagnosis by its core features and its first-line treatment. Then use the flashcards and the other Psychiatry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.