A 34 year old woman with fibromyalgia has been taking a selective serotonin and norepinephrine reuptake inhibitor. Which class of medicines is contraindicated in this patient?

A. Non steroidal anti-inflammatories: NSAIDs can be used concurrently with SNRIs for pain management, although they may increase the risk of gastrointestinal bleeding. This interaction requires monitoring rather than avoidance. They are not pharmacologically contraindicated. B. Monoamine oxidase Inhibitors: Concurrent use of MAOIs with SNRIs can lead to excessive accumulation of serotonin and norepinephrine. This interaction significantly increases the risk of serotonin syndrome and hypertensive crisis. A washout period is required when switching between these classes. C. Steroids: Corticosteroids do not have a direct pharmacodynamic interaction with SNRIs. While steroids may affect mood or glucose regulation, they can be used when clinically indicated. No absolute contraindication exists. D. Benzodiazepines: Benzodiazepines may be prescribed alongside SNRIs for anxiety or sleep disturbances. Additive sedation can occur, but this represents a precaution rather than a contraindication. Careful dosing and monitoring are sufficient.