Use Case 1
New Sertraline Initiation Assessment
Trigger: Provider considering sertraline for a new patient
1.Retrieve patient meds, conditions, allergies, labs, and family history via FHIR
2.Run Module 1 safety screening (MAOIs, pimozide, thioridazine, serotonergic burden, bipolar history)
3.Apply Hunter Criteria check if any serotonergic agents are present
4.Flag FDA Black Box paediatric monitoring requirements if patient is under 24
5.Evaluate Module 2 dosage appropriateness against AACAP guidance and FDA labelling
6.Assess Module 3 risk factors (hepatic impairment, seizure history, bleeding risk, pregnancy, CYP2C19)
7.Generate structured assessment PDF with findings, alerts, and PharmD assignments
8.Set up monitoring schedule per Black Box and activation-syndrome protocol
✓
Provider has a documented, evidence-cited initiation decision with monitoring schedule and PharmD review queued.
Use Case 2
Drug Interaction Hard Stop
Trigger: Sertraline added to a medication list containing an absolute contraindication
1.Detect the conflicting agent (MAOI, pimozide, thioridazine)
2.Issue HARD STOP and terminate forward modules
3.Surface the FDA prescribing-information citation and the Hunter Criteria mechanism
4.Generate PharmD escalation packet with full patient context
5.Recommend washout protocol or alternative therapy options
6.Mark all unstarted modules as 'skipped — hard stop'
7.Log decision to medical record with timestamp and rationale
✓
Catastrophic prescribing error blocked at the point of decision with full audit trail.
Use Case 3
Long-Term Management & Taper Planning
Trigger: Patient meets remission criteria (GAD-7 < 5 for ≥6 months) or requests discontinuation
1.Pull GAD-7 trajectory and total treatment duration
2.Apply AACAP continuation guidance for the patient's diagnosis
3.Recommend continue, watchful continuation, or taper
4.If tapering, generate a FINISH-aware schedule with check-in cadence
5.Flag activation-syndrome history, polypharmacy, or pharmacogenomic risk for PharmD consult
6.Schedule discontinuation symptom monitoring at 1, 2, and 4 weeks
✓
Discontinuation handled with structured taper, withdrawal monitoring, and PharmD oversight rather than abrupt stoppage.
Integrations
EHR / FHIR R4 API (Epic, Cerner, athenahealth)
FDA Prescribing Information Reference
Drug Interaction Database (Lexicomp, First Databank)
CPIC Pharmacogenomic Guidelines
PharmD Escalation Workflow
Clinical Document Generation (Assessment PDFs)
Industries
healthcare
See It In Action
A sample conversation with this agent
Starting a sertraline assessment for Ethan Nguyen—paediatric patient with GAD.
Pulling Ethan's record. He's 14, currently on methylphenidate for ADHD, no prior SSRI exposure. Loading the AACAP paediatric anxiety pathway. Module 0 retrieved: meds, conditions, allergies, recent labs (LFTs normal, no CBC concerns), no bipolar family history. Two items to flag before we begin: (1) methylphenidate—moderate serotonergic interaction, requires cardiovascular monitoring during titration; (2) FDA Black Box paediatric suicidality warning applies—I'll set up the weekly × 4, biweekly × 4, monthly thereafter monitoring schedule once therapy is initiated. Starting Module 1: safety contraindications.
Patient is on phenelzine—they want to switch to sertraline.
HARD STOP. Phenelzine is an MAOI. The FDA label requires a 14-day washout between MAOI discontinuation and sertraline initiation in either direction—co-administration risk is fatal serotonin syndrome via the Hunter Criteria mechanism. Escalating to PharmD with: (a) the absolute contraindication flag, (b) the recommended washout protocol, (c) a request for psychiatric consultation if the patient's mental health risk during the washout window is concerning. Assessment paused at Module 1A. I won't proceed with any sertraline-specific guidance until the washout is documented and PharmD has signed off.
Ethan has been on sertraline 50mg for 14 months, GAD-7 down from 16 to 4. Should we taper?
Module 6 long-term management. Ethan is in clinical remission (GAD-7 below 5 for ≥6 months meets AACAP continuation criteria). Standard recommendation for paediatric anxiety is 6–12 months of continuation past remission, so he's at the decision point now. If you taper, I'll generate a FINISH-aware schedule: 50mg → 37.5mg × 2 weeks → 25mg × 2 weeks → 25mg every other day × 2 weeks → off, with weekly check-ins for FINISH symptoms (Flu-like, Insomnia, Nausea, Imbalance, Sensory disturbance, Hyperarousal). I'd flag the activation-symptom history and the methylphenidate cardiovascular load shift during taper—both worth a PharmD consult. Ready to generate the taper plan and PharmD escalation packet when you are.