A client recently diagnosed with a major depressive disorder reports use of herbal supplements. It is most important for the nurse to provide education about which supplement reported by the client?

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11ecbb05_ccae_7a7d_b433_dbf721c151d9_MD0009_00 St John's wort is an herbal supplement commonly used to treat depression and anxiety. Some clients with mild or moderate depression claim that its antidepressant effect is comparable to that of prescription medications. The herbal supplement mimics the action of selective serotonin reuptake inhibitors (SSRIs) by increasing available serotonin in the brain. Taken in combination with an SSRI (eg, sertraline, fluoxetine, citalopram, paroxetine), St John's wort may cause an excess of serotonin, resulting in serotonin syndrome, which is characterized by mental status changes, autonomic dysregulation, and neuromuscular hyperactivity. The client with a newly diagnosed depressive disorder will likely be prescribed an antidepressant. The nurse should teach the client not to take St John's wort concurrently with SSRIs to prevent serotonin syndrome (Option D). (Option A) Echinacea is commonly used to prevent or treat the common cold/flu, although there is no evidence of its efficacy. It is thought to work by stimulating the immune system. Worsening asthma and anaphylaxis have been reported. (Option B) Garlic is used to improve cholesterol and lower blood pressure. Ginkgo, garlic, and ginseng (the 3 Gs) increase bleeding risk when taken with anticoagulants or thrombolytics. (Option C) Glucosamine is used to improve joint function. Hypoglycemia may result when it is taken with antidiabetic drugs. Educational objective: Selective serotonin reuptake inhibitors and St John's wort increase serotonin levels in the brain. Clients taking both products concurrently are at risk for potentially life-threatening serotonin syndrome (agitation, confusion, tachycardia, diaphoresis, tremors, hyperreflexia).

A Client Recently Diagnosed with a Major Depressive Disorder Reports