Which parameter should be monitored closely for a client diagnosed with severe major depression taking escitalopram?

The emphasis on monitoring suicidal ideation in a client with severe major depression who is taking escitalopram is crucial due to the increased risk of suicidal thoughts and behaviors associated with both the condition itself and the initiation of antidepressant therapy. During the early phases of treatment, specifically in the first few weeks, there is a heightened risk as the medication may initially increase energy levels before mood states improve, potentially providing the individual with the means to act on suicidal thoughts they may have been experiencing.

Regularly assessing suicidal ideation allows healthcare providers to be proactive in managing these risks. It also provides an opportunity for timely interventions if any concerning changes in the client's mental state are observed. This vigilance is an essential component of effective care in managing major depressive disorder, particularly in cases considered severe.

While other factors like sleep, appetite, and energy level are also important indicators of a client's overall well-being and response to medication, none carry the same immediate risk implications as suicidal ideation. Monitoring these parameters can contribute to a comprehensive understanding of the client's progress and side effects but do not specifically address the acute safety issues posed by the severity of the depression and the treatment being administered.