A behavioral health clinic nurse assesses a 23-year-old client who started taking paroxetine 3 weeks ago. Which statement made by the client is most important for the nurse to investigate?

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Selective serotonin reuptake inhibitors (SSRIs) (eg, fluoxetine, paroxetine, sertraline, citalopram) are used to treat a number of psychiatric conditions (eg, major depressive disorder, generalized anxiety disorder). Clients usually see therapeutic effects in 1-4 weeks. SSRIs may increase the risk of suicide, especially in young adults (age 18-24) during initial therapy or after a dosage increase. A client who reports increased energy without a change in depressive feelings needs to be assessed and monitored for suicidal ideation or actions as the client may now have the energy to execute the suicide plan (Option B). Common, expected side effects of SSRIs include: Loss of appetite; weight loss or weight gain (Option A) Gastrointestinal disturbances (nausea, vomiting, diarrhea) Headaches, dizziness, drowsiness, insomnia (Options C and D) Sexual dysfunction Side effects should gradually diminish over 3 months, although some may persist. If symptoms are intolerable or a particular SSRI is ineffective, the client may be switched to a different antidepressant. Educational objective: Selective serotonin reuptake inhibitors (eg, fluoxetine, paroxetine, sertraline, citalopram) are used to treat psychiatric conditions (eg, major depressive disorder, generalized anxiety disorder). A client reporting increased energy with little or no reduction of depression needs immediate assessment for suicide risk.

A Behavioral Health Clinic Nurse Assesses a 23-Year-Old Client Who