What should the nurse instruct a 16-year-old client prescribed paroxetine to monitor for closely?

When a nurse instructs a 16-year-old client prescribed paroxetine, it is critical to emphasize the need to monitor for agitation closely. Paroxetine, an SSRI (selective serotonin reuptake inhibitor), is commonly used to treat depression and anxiety disorders, but it can also lead to an increase in suicidal thoughts and behaviors in adolescents, especially during the initial treatment phase or when doses are adjusted.

Agitation is specifically noteworthy as it can signify a worsening of mood symptoms, increased irritability, or restlessness, which may indicate that the medication is not having the desired therapeutic effect or could be leading to adverse effects. This is particularly relevant in younger populations, where any change in mood or behavior should be addressed immediately.

The other symptoms—headache, nausea, and fatigue—while they can occur with paroxetine, are generally less concerning than agitation in the context of assessing the client’s mental health and risk of self-harm. These side effects may be more transient and can often dissipate over time as the body adjusts to the medication. In contrast, monitoring for agitation aligns with the critical need to ensure safety and stability in a young client who is beginning treatment for mood disorders.