What are common adverse effects of SSRIs, and what safety concern should be monitored after initiation?

• A. Nausea, sexual dysfunction, insomnia; monitor for increased suicidal ideation or behavior in early treatment, especially in youth.
• B. Weight gain and sedation; monitor for rash.
• C. Hypertension and edema; monitor for kidney injury.
• D. Hyperactivity and euphoria; monitor for withdrawal symptoms.

Answer: (A)

SSRIs commonly cause nausea, sexual dysfunction, and sleep disturbances like insomnia. These effects show up early after starting treatment and can affect whether someone continues the medication, but they often improve over time or with dose adjustments.

The safety concern to monitor after initiation is the appearance or worsening of suicidal thoughts or behaviors, especially in children, adolescents, and young adults in the first weeks of therapy. This is why any new or escalating thoughts of self-harm should be checked regularly, with careful mood and behavior monitoring and safety planning as needed.

Other options don’t fit as well because weight gain or sedation is less central to SSRI profiles, rash is not a primary safety focus, hypertension/edema or kidney injury aren’t typical concerns with SSRIs, and hyperactivity/euphoria isn’t characteristic of SSRI effects (and withdrawal can occur with stopping rather than after starting).