A patient being treated for depression has been taking 300 mg amitriptyline (Elavil)daily for nearly a year.She calls her case manager at the mental health clinic,stating she stopped taking her antidepressant 2 days ago and has developed something like the "flu," with cold sweats,nausea,a rapid heartbeat,terrible nightmares when she sleeps,but no other symptoms.How should the nurse respond?

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The patient has symptoms associated with abrupt withdrawal of the tricyclic antidepressant.Taking a dose of the drug will ameliorate the symptoms,and discussing her plans with the physician will allow her to discuss the advisability of going off the medication and to be given a gradual withdrawal schedule if discontinuation is the decision.This situation is not a medical emergency,so the ER is not indicated.The situation is not "normal";she is likely experiencing withdrawal and is also at risk of worsening or triggering her depression if she stops her medication,so the decision should be made in collaboration with a mental health professional.Aspirin would have no benefit in this situation.Taking the medication every other day would reduce the drug levels she is exposed to,but not in a gradual way;tapering the dosage gradually is needed instead.

A Patient Being Treated for Depression Has Been Taking 300