A client has been taking 1,200 mg a day of St. John’s wort for the past year for symptoms of depression. Recently, the client has complained of side effects from this herbal remedy. Which symptom should the nurse expect the client to report?

Choice A reason: Restlessness is not a common side effect of St. John’s wort. While mood changes can occur, this herbal remedy is more associated with photosensitivity than agitation. Choice B reason: Hirsutism, or excessive hair growth, is unrelated to St. John’s wort use. This side effect is more commonly linked to hormonal imbalances or certain medications, not herbal antidepressants. Choice C reason: Photosensitivity is a well-documented adverse effect of St. John’s wort. The herb increases sensitivity to sunlight, leading to skin reactions such as rashes or burns. Clients taking this remedy should be advised to use sun protection and avoid prolonged sun exposure. Choice D reason: Insomnia can occur with some antidepressants, but it is not a primary side effect of St. John’s wort. The herb’s most notable adverse effect is its impact on skin sensitivity to light.