A patient is taking fluoxetine (Prozac) and wonders if adding St. John's wort would help the patient's depression symptoms. The nurse provides the patient with information regarding which adverse effect that occurs when taking fluoxetine and St. John's

wort in combination?
1. Gastrointestinal distress
2. Increased depressive symptoms
3. Mania
4. Serotonin syndrome


Answer: 4
Explanation: Fluoxetine (Prozac) is a selective serotonin-reuptake inhibitor (SSRI) used in the treatment of depression. SSRIs should not be combined with St. John's wort because too much serotonin presents a risk for serotonin syndrome, a potentially life-threatening condition. Combining fluoxetine and St. John's wort does not necessarily cause gastrointestinal distress, mania, or worsen depressive symptoms.

Nursing

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