Registered Practical Nurse (RPN) Practice Test

Clients prescribed with which class of antidepressants require close monitoring for serotonin syndrome due to possible drug interactions?

1. Tricyclic Antidepressants

2. MAOIs

3. SSRIs

4. NRIs

The correct answer is: SSRIs

Clients prescribed with selective serotonin reuptake inhibitors (SSRIs) require close monitoring for serotonin syndrome due to the way these medications interact with serotonin levels in the brain. SSRIs function by blocking the reuptake of serotonin into the presynaptic neuron, thereby increasing serotonin availability in the synaptic cleft. This enhancement of serotonin activity can lead to excess serotonergic stimulation, especially when combined with other medications that also increase serotonin levels. Serotonin syndrome is a potentially life-threatening condition characterized by symptoms such as agitation, confusion, rapid heart rate, dilated pupils, muscle rigidity, and in severe cases, seizures and unconsciousness. The risk of developing serotonin syndrome increases when SSRIs are used in conjunction with other serotonergic agents, such as another SSRI, monoamine oxidase inhibitors (MAOIs), certain analgesics, or herbal supplements like St. John's Wort. While other classes of antidepressants, such as tricyclic antidepressants, MAOIs, and NRIs, have their own side effects and risks, they do not elevate serotonin levels to the same degree or mechanisms as SSRIs. Therefore, patients on SSRIs particularly warrant vigilant monitoring for signs of serotonin syndrome whenever there is a change in their medication regimen or if they