A patient tells the nurse she is going to try supplementing her selective serotonin reuptake inhibitor with St. John's wort. Which action should the nurse take first?
a. Assess the patient for depression and risk for suicide.
b. Advise her of the danger of serotonin syndrome.
c. Suggest that aromatherapy may produce even better results.
d. Suggest she consider decreasing the dosage of her antidepressant.
B
Research has suggested that St. John's wort is a mild inhibitor of serotonin reuptake and could lead to serotonin syndrome; this risk is increased if the patient is taking other medications that increase serotonin activity. Assessing the depression would be a secondary intervention. Aromatherapy has not been shown to be an effective adjunct or treatment for depression. Although a dosage reduction in her SSRI medication might reduce the risk of serotonin syndrome, it should only be attempted under the guidance of her prescribing health care provider.
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