Implementation

• Do not confuse nortriptyline with desipramine

• Taper to avoid withdrawal effects. Reduce dose 50% for 3 days, then by 50% for 3 more days, then discontinue

• PO: Administer medication with meals to minimize gastric irritation

» May be given as a single dose at bedtime to minimize sedation during the day. Dose increases should be made at bedtime because of sedation

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