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. Adding an MAOI (monoamine oxidase inhibitor) is not typically the first step when a client does not respond to an SSRI like citalopram. The nurse should not suggest this without consulting the provider and considering other options. B. The fact that the client has experienced some improvement (in appetite) suggests that the current medication is having some effect. It is premature to recommend switching medications at this point, as antidepressants typically take several weeks to show full effects. C. This is the most appropriate response. Antidepressants like citalopram can take several weeks to reach their full therapeutic effect. The nurse should provide education to the client that it may take more time for the medication to alleviate all symptoms, including sleep disturbances. D. A sleep study is generally not needed for clients who are experiencing sleep difficulties as part of their depressive disorder. It is more appropriate to focus on the expected effects of the antidepressant and possible adjustments to treatment after further evaluation.