The patient has been receiving amitriptyline (Elavil) for 2 weeks. He tells the nurse he doesn't think this medicine is working, as he is still depressed. What is the best response by the nurse?
1. "It is working, but it can take several weeks to have an effect."
2. "You might still feel depressed, but you are looking much better."
3. "This may not be the best medicine for you; I'll call your doctor."
4. "It is working, but it can take several months to have an effect."
Correct Answer: 1
Rationale: The therapeutic effects of tricyclic antidepressants may take 2 to 6 weeks to occur. It is inappropriate for the nurse to call the physician; tricyclic antidepressants need time to work. Telling a depressed patient he looks better negates the patient's feelings and is inappropriate. The time frame for efficacy is several weeks, not several months.
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