A patient explains to a nurse that he had been taking amitriptyline (Elavil) for depression and that his physician changed his medication to clomipramine (Anafranil). The patient is confused and does not understand why his medication was changed

Question

The nurse's best response to the patient would be what? A) "These drugs are similar but some patients respond better to one drug than another."
B) "Did you take the amitriptyline like you should have?"
C) "Maybe the old medicine wasn't working anymore."
D) "Clomipramine is newer and will be much better for you."

Answer 1

A
Feedback:
Because all tricyclic antidepressants (TCAs) are similarly effective, the choice of which TCA depends on individual response to the drug and tolerance of adverse effects. A patient who does not respond to one TCA may respond to another drug from this class. In addition, the nurse might inform the physician of the patient's question so the physician can explain his or her rationale for changing medications. By asking the patient if he took the medication as prescribed, the nurse is insinuating that he may not have and could damage the trusting nurse–patient relationship. The nurse has no basis for commenting that the medication might not be working or that another drug would work better.