Phone Visit
Narrative: SPRUCE MESSAGE VISIT Date: 2024-08-19 Encounter: Spruce text message CC: Continued ear and throat soreness with no fever, plus discussion of initiating Strattera (atomoxetine) for ADHD and anxiety. HPI: Miles had ongoing intermittent soreness in his ear and throat with no fever, persisting from around the time of the August 17 episode. He slept unusually late (until 9am) and woke in a good mood. Separately, the parent raised concerns about initiating Strattera (atomoxetine), a medication previously discussed for ADHD and anxiety. The parent had reviewed the medication and was concerned about the black box warning for suicidal ideation, as well as side effects including stomach issues and mood swings. Assessment: The physical symptoms (ear and throat soreness, no fever) were not further assessed beyond acknowledgment. Regarding Strattera: Dr. Hobbs explained it is a SNRI approved for both ADHD and mood issues including anxiety, and that effects may take a few weeks to become apparent. A trial was agreed upon. Plan: Prescription sent for Strattera to CVS Target in Richfield. Timing of dose noted as not particularly important with this medication. Family advised to expect 1–2 weeks before seeing benefit. Guanfacine discussed as a potential future addition depending on SNRI/SSRI response. Medications: - Strattera (atomoxetine) UNSPECIFIED starting dose — prescription sent (new) Key clinical quotes: "Strattera specifically is approved for adhd as well as mood issues, like anxiety" "I think it's something that could help, the difference being that it might take a week or two to see if it's helping or not" "it may take a few weeks to see who well it will work" Source: Spruce conversation t_25GF4V55J8800