The patient has been receiving escitalopram (Lexapro) for treatment of obsessive-compulsive disorder. Unknown to the nurse, the patient has also been self-medicating with St. John's wort
The patient comes to the office with symptoms of hyperthermia and diaphoresis. Which statement best describes the result of the nurse's assessment?
1. The patient is experiencing symptoms of St. John's wort toxicity, as the medication was most likely outdated.
2. The patient has contracted a viral infection. Escitalopram (Lexapro) and St. John's wort are safe to take together.
3. The patient has not been taking escitalopram (Lexapro) and is experiencing withdrawal.
4. The patient has combined two antidepressant medications and is experiencing serotonin syndrome.
Correct Answer: 4
Rationale: Use caution with herbal supplements such as St. John's wort, which may increase the effects of escitalopram (Lexapro) and cause serotonin syndrome. The patient's symptoms are consistent with serotonin syndrome, and there is no evidence that the patient has not been taking the escitalopram (Lexapro). The patient's symptoms are consistent with serotonin syndrome, and there is no evidence that the patient's St. John's wort is outdated. The patient's symptoms are consistent with serotonin syndrome. It is not considered safe to combine escitalopram (Lexapro) and St. John's wort.
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