Two weeks ago, the PMHNP prescribed the antidepressant escitalopram (Lexapro) for a 28-year-old female client with generalized anxiety disorder. At her initial appointment, she scored 28 on the Hamilton Anxiety Rating Scale (HAM-A). At today’s follow-up visit, she scored 26. She reports no side effects from the Lexapro. Which of the following is the next step for the PMHNP?

Choice A reason: Discontinuing an antidepressant after only two weeks with minimal improvement is premature; SSRIs often require 4–6 weeks for full efficacy. Choice B reason: Making no changes is appropriate at this stage, as early treatment response is modest. The clinician should continue monitoring and reassess after sufficient treatment duration. Choice C reason: Adding an augmenting agent is not indicated yet, given the patient has only had two weeks of therapy and lacks significant side effects. Choice D reason: Switching antidepressants is premature at this early stage of treatment; efficacy assessment requires adequate duration.