A patient diagnosed with depression confidently tells the nurse, "I've been supplementing my paroxetine (Paxil) with St. John's wort. It has helped a great deal." What is the nurse's priority action?
a. Assess changes in the patient's level of depression.
b. Remind the patient to use a secondary form of birth control.
c. Educate the patient about the risks of selective serotonin syndrome.
d. Suggest adding valerian to the treatment regimen to further improve results.
ANS: C
Research has suggested that St. John's wort inhibits serotonin reuptake by elevating extracellular sodium; thus, it may interact with medication, particularly selective serotonin reuptake inhibitors, to produce serotonin syndrome. Discussing the patient's birth control method is a secondary priority.
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