Discussion

Consider the following scenario

Faye, a 20-year-old student from Germany, seeks medical attention at the urging of her roommates, who report that her mood has become increasingly depressed during the past two semesters.  She is withdrawn and moody, which is a significant change from her affect since first coming to the United States to attend college.  She is otherwise healthy.

Assessment Findings:

Subjective (from patient statements):

· 10 lb weight loss during last 3 months

· takes oral contraceptives for regulation of menses

· reports smoking a pack of cigarettes per day

· reports taking St. John’s Wort to treat her depression upon suggestion by her mother who has used the product for the past 10 years

Medical Plan:

· immediately start Faye on sertraline (Zoloft) 50 mg once per day

· recommend individual counseling therapy 

Class:  Zoloft is a selective serotonin reuptake inhibitor (SSRI).  How do SSRIs work?  What is St. John’s Wort?  How does St. John’s Wort work as an antidepressant?  What is your immediate concern regarding Faye’s use of St. John’s Wort?