What should clinicians monitor for in patients starting on antidepressants, particularly in the first month?

Clinicians should closely monitor changes in mood and behavior, including any suicidal thoughts, in patients starting on antidepressants, especially within the first month of treatment. This period is critical as the onset of antidepressant effects can vary, and there is a concern for increased suicidality in some patients, particularly adolescents and young adults. While many antidepressants may take several weeks to show their full therapeutic effects, there can be a transient worsening of mood or the emergence of suicidal thoughts in the early stages of treatment.

Additionally, effective monitoring during this period helps ensure that any adverse effects are promptly addressed, which is essential for patient safety. Regular check-ins allow clinicians to assess how the patient is responding to the medication and to make necessary adjustments to the treatment plan. Although monitoring for changes in appetite and weight, sleep patterns, and physical activity levels are important in the overall management of depression, the primary concern during the initial phase of antidepressant therapy centers on the patient's psychological well-being and risk of suicide.