Patient/caregiver was educated on the side-effects of using Amitriptyline as follows:

Musculoskeletal side-effects

• Amitriptyline intake carries the risk of lowering the threshold for seizures, thereby, resulting in seizure activity, especially in individuals with history of the same.

• Amitriptyline intake can also induce a life-threatening reaction called Neuroleptic malignant syndrome. Individuals taking amitriptyline can present with high fever, episodes of confusion, muscle rigidity, elevated blood pressure, and rapid heart rate. Severe cases can present with muscle breakdown, elevated potassium levels in the blood due to muscle destruction, life-threatening cardiac arrhythmias due to the elevated blood potassium, and seizures.

Genitourinary side-effects

• Amitriptyline can also induce retention of urine in the bladder and difficulty with emptying the bladder.  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.