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 some improvement but still feels very depressed and is still having trouble sleeping. Which of the following actions should the nurse take?

Choice A reason: Adding an MAOI to citalopram is contraindicated due to risk of serotonin syndrome, which can be fatal. This is not appropriate. Choice B reason: Changing the medication after only 2 weeks is premature. Antidepressants typically require 4–6 weeks for full effect. Switching too early may prevent therapeutic benefit. Choice C reason: This is the correct response. Antidepressants often take several weeks to reach full effectiveness. The nurse should provide education and reassurance, helping the client understand the expected timeline. Choice D reason: A sleep study is not indicated at this stage. The sleep disturbance is likely related to depression and incomplete therapeutic effect of the medication.