Ten days after attempting suicide using an antidepressant medication, a 23-year-old woman receives a prescription for venlafaxine. She becomes tachycardic, diaphoretic, and develops myoclonic jerks. Which of the following medications did she take to attempt suicide?

Choice A reason: Bupropion is a norepinephrine-dopamine reuptake inhibitor and does not significantly increase serotonin levels. While it can cause seizures in overdose, it is not typically associated with serotonin syndrome. Choice B reason: Phenelzine is a monoamine oxidase inhibitor (MAOI) that prevents the breakdown of serotonin. When combined with venlafaxine, a serotonin-norepinephrine reuptake inhibitor (SNRI), it can lead to dangerously elevated serotonin levels and trigger serotonin syndrome. The symptoms described—tachycardia, diaphoresis, and myoclonic jerks—are classic signs. Choice C reason: Lorazepam is a benzodiazepine and acts on GABA receptors. It does not affect serotonin levels and is not implicated in serotonin syndrome. Choice D reason: Hydroxyzine is an antihistamine with anxiolytic properties. It does not influence serotonin metabolism and is not associated with serotonin syndrome.