Pharmacology Antidepressants #1

Question

The client’s spouse comments to the clinic nurse, “I am so glad the antidepressant has started working. It has been a long two weeks. Now, I don’t have to worry that she will try to commit suicide.” What is the nurse’s best and most therapeutic response?

Answers

  1. "If I was you, I would never trust that she won’t commit suicide. Once you consider it, it is always a risk."
    • Rationale:

      This answer is not correct because this statement is not necessarily true. Once the client’s depression is properly treated and hormones in the brain are increased, many clients do not consider suicide as an option. Furthermore, “If I was you…” is not the most therapeutic statement because the nurse is offering an opinion.

  2. "There is no need to worry about that now. You got her in just in time."
    • Rationale:

      This answer is not correct because this statement is not true. The first weeks of antidepressant therapy, the client is at an increased risk of suicide. This is because as the client begins to “feel better”, the client may only have increased energy enough to follow through with suicidal intentions. The family and friends of the client should be educated about this increased risk and plan to more carefully monitor the client for this. Furthermore, this statement also give false assurance, which is not a therapeutic response.

  3. "Why would you worry about her committing suicide. She has you and a beautiful family."
    • Rationale:

      This answer is not correct because this response is nontherapeutic. Asking a person, “Why” can make the person feel embarrassed or defensive about the feelings they should have. Furthermore, a depressed person is focused on themselves and their hopelessness, not on how great their family is.

  4. "You should continue to watch her because now she may have the energy to act on her intentions."
    • Rationale:

      This answer is correct because during the first weeks of antidepressant therapy, the client is at an increased risk of suicide. This is because as the client begins to “feel better”, the client may only have increased energy enough to follow through with suicidal intentions. The family and friends of the client should be educated about this increased risk and plan to more carefully monitor the client for this.

Overview

The client should be monitored carefully in the first weeks of antidepressant therapy because, at first, the client may feel just enough better to have the energy to follow through with suicidal intentions.

Explanation

Learning Outcomes

Many antidepressants take as much as 6 weeks to be completely effective. The first weeks of antidepressant therapy, the client is at an increased risk of suicide. This is because as the client begins to “feel better”, the client may only have increased energy enough to follow through with suicidal intentions. The family and friends of the client should be educated about this increased risk and plan to more carefully monitor the client for this.

Test Taking Tip

When determining if a response is therapeutic or not, quickly eliminate any response that begins with “Why”.

Video Rationale