Phone Visit
Narrative: SPRUCE MESSAGE VISIT Date: 2025-06-14 Encounter: Spruce text message CC: Sertraline dose increase to 50mg with ongoing monitoring for efficacy and side effects including emotional blunting. HPI: Eamon returned from swim camp and parents increased sertraline from 25mg to 50mg per the prior plan. The original 30-count of 25mg tablets was nearly depleted. Parents subsequently reported that after several weeks on 50mg, they were not seeing clear improvement in mood or behavior, and Eamon was self-reporting anhedonia/emotional blunting — describing feeling 'meh' and losing enjoyment of activities like swimming. Parents noted this matched the medical literature on SSRI blunting, which they had not disclosed to Eamon. Dr. Hobbs consulted Rachelle Hansen (therapist) by phone, who also recommended continuing at the current dose. A refill was sent for sertraline at 75mg. Assessment: Sertraline at 50mg showing possible emotional blunting as a side effect; clinical efficacy for mood/behavioral improvement unclear. After consultation with therapist Rachelle Hansen, decision made to continue and increase to 75mg given the plan going into the school year. Plan: Sertraline increased to 50mg after swim camp. Insurance/refill barrier addressed. After discussion with Rachelle Hansen, sertraline refilled at 75mg to Walgreens on Vernon. Continue monitoring. Medications: - Sertraline Increased from 25mg to 50mg, then refilled at 75mg (adjust) Key clinical quotes: "I spoke with Rachelle this morning and she also feels it would be good to continue at the current dose and plan going into school" "I've sent a refill for the sertraline at 75mg to Walgreens on Vernon" Source: Spruce conversation t_27GA7V0S3U800