What is the main priority assessment for a teenager recently prescribed an SSRI?

The primary concern when assessing a teenager prescribed a selective serotonin reuptake inhibitor (SSRI) is the risk of suicidal ideation. SSRIs can sometimes increase the risk of suicidal thoughts and behaviors in children and adolescents, particularly during the initial treatment period or when doses are adjusted. This heightened risk necessitates close monitoring for any signs of worsening depression or emergence of suicidal thoughts, prompting ongoing discussions with the patient and their support system about any changes in mood or behavior.

While assessments such as cardiac rate and rhythm, hypomanic states, and venous thromboembolism are important in different contexts, they do not hold the same urgency for this specific group of patients. The focus on suicidal ideation is rooted in the understanding that the stakes are particularly high during the early phases of antidepressant therapy, necessitating vigilant observation and timely intervention if any alarming thoughts or behaviors arise. This approach ensures that healthcare providers can respond swiftly if the patient shows any signs of distress.