A nurse is planning care for a hospitalized client newly prescribed antidepressant medication for major depressive disorder. Which rationale best supports the need for close monitoring during the initial phase of therapy?

A. Antidepressants have immediate therapeutic effects, requiring rapid dose adjustments: Antidepressants do not have immediate effects; they typically take 2 to 6 weeks to achieve therapeutic benefit. Rapid dose adjustments are not usually necessary during the initial phase. B. Clients often experience improved energy before mood lifts, increasing suicide risk: Early in treatment, clients may regain energy before their depressive symptoms improve. This can increase the risk of acting on suicidal thoughts, making close monitoring critical for safety during the initial phase of therapy. C. Antidepressants may cause sedation, leading to decreased fall risk in the early phase: While sedation can occur, it may actually increase fall risk rather than decrease it. Sedation is a side effect that requires monitoring but is secondary to suicide risk in priority. D. Most clients become nonadherent due to side effects within the first 72 hours: Nonadherence can develop over time due to side effects, but the immediate concern in the first few days is monitoring for increased energy and potential suicidal ideation rather than adherence alone.