Antidepressants — teaching and monitoring
Full effect on mood takes two to six weeks. Energy and psychomotor activity often improve first, and that gap is the period of heightened suicide risk: monitor closely in the first weeks and after every dose increase. Never stop abruptly: discontinuation syndrome brings dizziness, flu-like symptoms, electric-shock sensations, irritability. Watch for serotonin syndrome when a second serotonergic agent is added, and for a switch to mania in bipolar disorder. SSRIs also cause hyponatremia in the older adult.