A nurse is caring for a client who has major depressive disorder and was prescribed citalopram 2 weeks ago with a planned dosage increase 1 week ago. The client reports having an improved appetite, but still feels very depressed and is still having trouble sleeping. Which of the following actions should the nurse take?

A. Recommend a sleep study be done on the client: Insomnia is a common symptom of depression and can also be a temporary side effect of starting SSRIs. It is too early to suspect a separate sleep disorder requiring a study. B. Tell the client that the provider will need to change citalopram to a different medication: Two weeks is not a sufficient trial period for SSRIs. Changing medication now would be premature. C. Speak to the provider about adding an MAOI to the current medication regimen: This is a critical safety error. Combining an SSRI (Citalopram) with an MAOI can cause Serotonin Syndrome, a life-threatening condition. A "washout period" of at least 2 weeks is required between stopping one and starting the other. D. Explain that antidepressants often take several weeks to be fully effective: SSRIs (Selective Serotonin Reuptake Inhibitors) typically take 4 to 6 weeks to reach full therapeutic effect for mood elevation. It is a common phenomenon that physical symptoms (like energy or appetite) improve before the mood improves. This puts the client at higher risk for suicide (as they now have the energy to carry out a plan), so the nurse must educate the client to continue the medication and monitor for safety.