amitriptyline
hydrochloride
Apo-amitriptyline (CAN), Endep, Levate
(CAN), Novotriptyn (CAN)
Nursing Considerations
• Because of amitriptyline’s atropine-like
effects, use caution if patient has a history
of seizures, urine retention, or angleclosure
glaucoma.
WARNING Don’t give an MAO inhibitor
within 14 days of amitriptyline because of
the risk of seizures and death.
• Closely monitor patient with CV disorder
because amitriptyline may cause arrhythmias,
such as sinus tachycardia.
•Watch patients closely (especially children,
adolescents, and young adults), for suicidal
tendencies, particularly when therapy
starts and dosage changes. Depression may
worsen temporarily during these times.
•Monitor blood pressure for hypotension
or hypertension.
• Stay alert for behavior changes, such as
hallucinations and decreased interest in
personal appearance. Be aware that psychosis
may develop in schizophrenic
patients, and symptoms may increase in
paranoid patients.
• Abrupt withdrawal after long use may
cause nausea, headache, vertigo, and
nightmares.
PATIENT TEACHING
• Instruct patient to take amitriptyline at
bedtime to avoid daytime drowsiness.
• Instruct patient to avoid using alcohol or
OTC drugs that contain alcohol during
amitriptyline therapy because alcohol
enhances CNS depressant effects.
• Urge family or caregiver to watch patient
closely for suicidal tendencies, especially
when therapy starts or dosage changes and
particularly if patient is a child, teenager,
or young adult.
