a preponderance of the cis doxepin isomer over the trans doxepin isomer provide therapeutic effects for affective painful or allergic disorders without the sedative effects commonly experienced with compositions having a preponderance of the trans doxepin isomer application_number US 37253509 A description in accordance with the invention formulations are provided that incorporate a preponderance of the cis doxepin isomer over the trans isomer into pharmaceutically acceptable vehicles suitable for use in human patients such formulations include those for application to the skin such as solutions creams ointments gels lotions or pastes such formulation also include those for application to mucous membranes including ophthalmic and nasal solutions and solutions and suspensions suppositories and plasticized formulations suitable for oral and vaginal applications cis doxepin may also be formulated in sterile solutions or suspensions suitable for intradermal subcutaneous intramuscular intravenous or cerebrospinal injection in each of the foregoing formulations whether for application to the skin application to the mucous membranes or for injection the cis doxepin isomer may be present in the amount of about 0 01 to about 10 by weight and preferably about 0 05 to about 5 by weight and any trans doxepin isomer that may be present is in an amount less than that of the cis doxepin isomer formulations within the scope of the invention also includes those suitable for oral administration such as capsules tablets or liquid solutions or suspensions in such formulations the cis doxepin isomer may be present in amounts of about 0 5 500 0 mg and preferably about 1 0 50 0 mg per tablet capsule or 5 ml dose of liquid solution or suspension and any trans doxepin isomer that may be present is in an amount less than that of the cix doxepin isomer suitable pharmaceutical vehicles for the.