Certified Diabetes Care and Education Specialist (CDCES) Practice Exam

Which medication should not be prescribed to patients taking lorcaserin for weight loss?

1. Atorvastatin

2. Metformin

3. Fluoxetine

4. Lisinopril

The correct answer is: Fluoxetine

Lorcaserin is a medication used for weight management that acts as a selective serotonin receptor agonist, specifically targeting the 5-HT2C receptor. When considering drug interactions with lorcaserin, it's important to recognize the potential for serotonin syndrome, a serious condition that can occur when medications that increase serotonin levels are combined. Fluoxetine is an SSRI (selective serotonin reuptake inhibitor) that increases serotonin levels in the brain. Although it can be beneficial for treating depression and anxiety, using it concurrently with lorcaserin increases the risk of serotonin syndrome, leading to symptoms such as agitation, confusion, rapid heart rate, and hypertension. This dangerous interaction makes it advisable to avoid prescribing fluoxetine to patients who are also taking lorcaserin. The other medications listed—atorvastatin, metformin, and lisinopril—are not known to have significant interactions with lorcaserin, allowing for their concurrent use without the heightened risk of serotonin-related complications. Atorvastatin is a cholesterol-lowering drug, metformin is commonly prescribed for diabetes management, and lisinopril is an antihypertensive medication. None of these medications are known to affect serotonin levels or interact with lorcaserin in a way that poses