Major Depressive Disorder Has in Medicine / Internal Medicine — 45yo Woman | Psychiatry | SMLE Q#1423
SMLE Question #1423
Medicine / Internal Medicine
Psychiatry
Last updated: February 2026
A 45-year-old woman with major depressive disorder has been taking amitriptyline 75 mg once daily for 3 weeks. Her mood and sleep are improving, and she wants to continue the same medication. Since starting treatment, she has marked dizziness and lightheadedness each morning when standing up from bed. She takes the dose at 07:00 with breakfast and has no other medications. What is the most appropriate next step in management to reduce these morning symptoms while maintaining efficacy?
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