What should a nurse inquire about in a client taking both citalopram and St. John's wort?

When a client is taking both citalopram, which is an SSRI antidepressant, and St. John's wort, a herbal remedy often used for treating depression, it is crucial to inquire about the potential side effects of serotonin syndrome. This condition occurs when there is an excess of serotonin in the nervous system, which can result from the combination of these two medications. St. John's wort can increase serotonin levels, thus enhancing the effects of citalopram.

Symptoms of serotonin syndrome may include confusion, rapid heart rate, high blood pressure, dilated pupils, muscle rigidity, and gastrointestinal symptoms. Given the pharmacological interaction between an SSRI and St. John's wort, monitoring for signs and symptoms of serotonin syndrome is essential to ensure the client's safety and mitigate any life-threatening effects. Recognizing these symptoms early can lead to prompt intervention and management of the condition.