A nurse is teaching a client who is to start taking fluoxetine. The nurse should instruct the client that which of the following supplements Interacts adversely with fluoxetine?
A.
Soy protein
B.
Echinacea
C.
St. John’s wort
D.
Ginkgo biloba
The correct answer and Explanation is :
The correct answer is C. St. John’s wort.
Explanation:
Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) commonly prescribed for depression, anxiety, and other mood disorders. SSRIs work by increasing the level of serotonin, a neurotransmitter, in the brain. While fluoxetine is generally effective, it can interact with certain supplements, particularly those that also affect serotonin levels.
St. John’s wort is a herbal supplement often used to treat mild to moderate depression. It affects serotonin, norepinephrine, and dopamine levels in the brain, which can lead to increased serotonin activity. When combined with fluoxetine, St. John’s wort can significantly elevate serotonin levels, leading to a dangerous condition known as serotonin syndrome.
Serotonin syndrome is a potentially life-threatening condition that occurs when there is too much serotonin in the brain. Symptoms of serotonin syndrome include:
- Agitation or restlessness
- Confusion
- Rapid heart rate
- High blood pressure
- Dilated pupils
- Muscle rigidity
- Sweating
- Diarrhea
- Severe cases can result in seizures or unconsciousness.
Since fluoxetine and St. John’s wort both increase serotonin, taking them together increases the risk of serotonin syndrome, making this an adverse interaction.
Other Options:
- Soy protein (A): There is no significant evidence that soy protein interacts adversely with fluoxetine.
- Echinacea (B): Echinacea is an herbal supplement typically used to boost the immune system. There is no direct interaction between echinacea and fluoxetine.
- Ginkgo biloba (D): Ginkgo biloba is used to improve memory and circulation. While it may interact with other medications (e.g., anticoagulants), there is no substantial evidence of it causing adverse effects with fluoxetine.
Thus, clients should be advised to avoid using St. John’s wort while taking fluoxetine to prevent serious complications.