The Nurse Practitioner prescribes Amitriptyline (Elavil) to a patient with Major Depressive Disorder (MDD). What are potential side effects that the NP should educate the patient on? SELECT THREE

A. Sedation: Amitriptyline is a tricyclic antidepressant with strong antihistaminic properties, leading to central nervous system depression. Sedation is common, especially at initiation or with dose increases. This effect often influences dosing at bedtime. B. Weight loss: Tricyclic antidepressants are more commonly associated with weight gain due to increased appetite and metabolic changes. Weight loss is not a typical effect of amitriptyline. Appetite stimulation is more likely than suppression. C. Dry mouth: Amitriptyline has significant anticholinergic activity, which decreases salivary gland secretion. Xerostomia is a frequent and bothersome adverse effect. Anticholinergic symptoms require patient education to support adherence and safety. D. Orthostatic hypotension: Alpha-1 adrenergic blockade caused by tricyclic antidepressants can impair vascular tone. This leads to blood pressure drops upon standing, increasing fall risk. Older adults are particularly susceptible to this effect.