1. Education to Patient
    1. When counseling patients with depression who are receiving antidepressant medications, the patient should be informed that adverse effects might occur immediately, while resolution of symptoms may take 2 to 4 weeks or longer. Adherence to the treatment plan is essential for a successful outcome, and tools to help increase medication adherence should be discussed with each patient.
    2. Do not discontinue without talking to provider first
    3. Need of routine use
    4. Avoid alcohol/CNS depressants
    5. Risk of suicidality
    6. Report any worsening of depression and/or suicide ideation to provider
  2. Interview Questions:
    1. What are your symptoms? Have you had these symptoms before?
    2. How long have you felt this way?
    3. Have you had any problems concentrating or problems remembering?
    4. Have you thought about death or suicide?
    5. What social support do you have?
    6. Would you be willing to do/try CBT (therapy)?

Serotonin syndrome: mental status changes, autonomic instability, gastrointestinal symptoms, neuromuscular changes, seizures. Occurs when multiple serotonergic medications are used together