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A 76-year-old woman was admitted five days ago with a severe depressive episode. Her general practitioner started amitriptyline 75 mg at night three weeks ago and it was continued on admission; she also takes perindopril. Today the nurses record that she is drowsy through the morning, agitated after dark, and cannot recite the months of the year backwards, though she managed it yesterday. She says there are children playing in the corner of the room. Her observations are normal, her mouth is dry and her bowels have not opened for four days. Which one of the following changes to her management is most appropriate?
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