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?

The correct answer is B. The nurse should explain that antidepressants often take several weeks to be fully effective. This is because it takes time for the medication to reach therapeutic levels in the body and for the brain chemistry to adjust. It is common for patients to experience some improvement in certain symptoms like appetite before seeing a significant improvement in mood and sleep. Adding an MAOI (choice A) is not recommended due to the risk of serotonin syndrome when combined with SSRIs like citalopram. Changing the medication (choice C) should only be considered if there is no improvement after a sufficient trial period. Recommending a sleep study (choice D) is premature as the client's sleep issue may improve with the current medication over time.