A 51-year-old woman with a history of generalized anxiety disorder (GAD) has been treated with 20 mg of paroxetine (Paxil) for 6 months. The dose was increased to 40 mg at her last visit 2 weeks ago due to increased symptoms of anxiety. Now she reports “hot flashes” and significant hyperhidrosis to her psychiatric mental health nurse practitioner. Which of the following statements is NOT correct about this clinical scenario?

Choice A reason: Hyperhidrosis is a known dose-dependent side effect of SSRIs, particularly paroxetine, making this statement correct. Choice B reason: Age-related changes in drug metabolism and hormone levels may reduce SSRI efficacy in women over 50, making this statement accurate. Choice C reason: This statement is not correct. While escitalopram may have a slightly lower risk of hyperhidrosis, switching without first evaluating dose adjustment or other interventions is not the standard first approach. The focus should be on managing side effects while maintaining therapeutic efficacy. Choice D reason: Reducing the dose and considering adjunctive therapies while evaluating hormonal status is an appropriate, evidence-based approach to managing SSRI-induced hyperhidrosis in this patient population.