Which of the following statements best describes a typical early safety consideration when starting an SSRI?

• A. Monitor for gastrointestinal upset only.
• B. Monitor for sexual side effects only.
• C. Monitor for suicidality in the first weeks of treatment.
• D. Monitor for blood pressure changes exclusively.

Answer: (C)

Starting an SSRI requires close attention to safety in the early weeks because some patients, especially younger individuals, may experience an emergence or intensification of suicidal thoughts or behaviors soon after starting treatment or after dose changes. This risk tends to be highest in the first few weeks, so proactive monitoring of mood, thoughts of death or suicide, agitation, irritability, and any sudden changes in behavior is essential. The goal is to catch any warning signs early and adjust treatment if needed, including safety planning and involving caregivers when appropriate. While gastrointestinal upset and sexual side effects are common with SSRIs, they are not the primary early safety concern, and blood pressure changes are not a typical, widespread early issue.