What condition should a nurse monitor for in a client taking St. John's wort and citalopram?

The condition to monitor for when a client is taking St. John's Wort alongside citalopram is serotonin syndrome. Both St. John's Wort and citalopram affect serotonin levels in the brain. St. John's Wort is known to be a natural antidepressant that can enhance serotonin activity, and citalopram is a selective serotonin reuptake inhibitor (SSRI) that also increases serotonin availability. When these two substances are combined, they can lead to an excessive accumulation of serotonin, potentially resulting in serotonin syndrome, which is characterized by symptoms such as confusion, agitation, rapid heart rate, fluctuating blood pressure, increased body temperature, and various neurological effects.

Monitoring for serotonin syndrome is crucial as it can be a life-threatening condition if not identified and treated promptly. Awareness of this risk enables nurses to educate their clients on the signs and symptoms of serotonin syndrome and to facilitate timely intervention should symptoms arise.