Patient/caregiver was educated on precautions to be exercised while taking amitriptyline as follows:
- Avoid using amitriptyline with other antidepressant medications that act along the same line as amitriptyline and increasing the serotonin levels in the body. Amitriptyline use along with antidepressants, such as, citalopram, fluoxetine, and sertraline, can significantly increase the serotonin levels in the body and lead to development of serotonin syndrome, thus resulting in nausea, vomiting, diarrhea, rapid heart rate and dangerous arrhythmias, mania, agitation, and hallucinations. Caution must be exercised even when discontinuing on any of the above mentioned antidepressant medications with potential to increase serotonin levels and starting on amitriptyline, by observing a window period of atleast 2 weeks, before the transition to amitriptyline is made, to prevent development of serotonin syndrome.
- Amitriptyline can also induce retention of urine in the bladder and difficulty with emptying the bladder and so, must be avoided/administered with caution in individuals with history of difficulty passing urine. Individuals with history of retention of urine and frequent urinary tract infections must be aware of this side-effect, as amitriptyline can exacerbate this condition significantly. Observing compliance with proper hydration measures, compliance with daily fluid intake recommendations, timed voiding, hygienic practices, and other UTI prevention measures can help reduce the risk of urinary retention and prevent development of any UTIs, secondary to amitriptyline intake.
- Observe compliance with all physician visits and periodical lab draws ordered, while taking amitriptyline, for an update on improvement/deterioration with symptoms of mood disorder and side-effects developed. This will also allow your physician to make appropriate changes in your plan of care, as needed.
