An adult woman is seeing a nurse therapist for depression. The client has been taking fluoxetine (Prozac) for 3 weeks, but her mood has not improved
She states, "I need more than this to get better so I'm taking St. John's wort, too." Why should the nurse tell the client to immediately stop taking St. John's wort?
A) St. John's wort with fluoxetine may lead to serotonin syndrome.
B) St. John's wort with fluoxetine may cause blood dyscrasias.
C) St. John's wort with fluoxetine may lead to liver failure.
D) St. John's wort with fluoxetine may lead to hypertensive crisis.
Ans: A
Feedback:
As with other phytomedicinals, St. John's wort is available in capsule, dried, and tincture forms but with varying degrees of potency. It is not a proven treatment for depression, but it is thought to increase serotonin levels. Therefore, taking St. John's wort along with a prescription antidepressant may cause central serotonin syndrome.
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