A 51-year-old woman with a history of generalized anxiety disorder (GAD) has been treated with 20 mg of paroxetine (Paxil) for 6 months. The dose was increased to 40 mg at her last visit 2 weeks ago due to increased symptoms of anxiety. Now she reports “hot flashes” and significant hyperhidrosis to her psychiatric mental health nurse practitioner. Which of the following statements is NOT correct about this clinical scenario?

The client is experiencing a dose-dependent antidepressant-related hyperhidrosis.

Selective serotonin reuptake inhibitors (SSRIs) may be less effective in women over 50, especially if they are not taking estrogen.

The PMHNP should switch the client to escitalopram (Lexapro), which has a lower potential for dose-dependent hyperhidrosis.

An appropriate next step would be to reduce the dose of paroxetine back to 20 mg, add a short-term adjunctive treatment for acute anxiety, and draw labs to check her hormone levels prior to making further medication changes.