The medication is clearly working as expected, so continue the current dose unchanged and schedule a routine follow-up appointment in four weeks.

While the early improvement is encouraging, the assessment should be more specific than "continue." Identifying which symptoms have improved and screening for emergent risks is essential.

Assess which specific symptoms have improved versus not, screen for emergent suicidal ideation during the early treatment risk window, evaluate side effects and adherence, and set realistic expectations for full response.

The PMHNP should assess the specific nature of the improvement (sleep, anxiety, energy, appetite vs. mood) to determine whether it tracks with the expected SSRI response timeline. Early improvement in sleep and anxiety is a positive prognostic sign. However, the period when energy improves before mood normalizes carries risk — a patient who was too fatigued to act on suicidal thoughts may now have the energy to do so. Explicit assessment of suicidal ideation is important at early follow-up visits.

Two weeks is too early for any genuine SSRI effect since full serotonergic remodeling takes 4-6 weeks, so any perceived improvement is likely placebo response.

SSRIs can produce measurable physiological effects within 1-2 weeks (serotonergic changes in sleep architecture, anxiety reduction). Dismissing early improvement as placebo is inaccurate.

Switch to a different antidepressant class, since partial response at 2 weeks is a well-established predictor of eventual treatment failure with the current agent.

Partial response at 2 weeks is actually a positive prognostic indicator. Adequate SSRI trials require 4-6 weeks at therapeutic doses before determining efficacy.