<format type="yaml">{report_id: string, report_date: date, patient_details: {patient_id: string, age_at_reaction: number optional, gender: string, relevant_history: list[string]}, suspected_drugs: list[{drug_name: string, drug_class: string optional, dosage: string, route_of_administration: string, start_date: date, end_date: date optional, indication_for_use: string}], adverse_reactions: list[{symptom_name: string, onset_date: date, severity: string, outcome: string, intervention_required: boolean, intervention_details: string optional}], causality_assessment: {naranjo_score: number optional, assessment_conclusion: string, dechallenge_rechallenge: string}, reporting_facility: string, reporter_type: string, notes: string optional}</format> <data>PHARMACOVIGILANCE CASE REPORT - CONFIDENTIAL
Report Identifier: ADR-2025-717
Date of Submission: 2025-01-19

This report was submitted by a Pharmacist from Wilkerson, Hale and Smith Medical Center concerning patient ANON-PX-1847. The subject is a 23-year-old other with a significant medical history including coronary artery disease, migraines. The facility's standard operating procedure for ADR reporting was followed, and all patient data has been anonymized. The patient chart was reviewed for comorbidities. 

Current medication review revealed the following suspected agent(s): Sertraline (SSRI) administered via the Oral route at a dosage of 327mg, initiated on 2024-12-26 for Major depressive disorder and discontinued on 2025-01-16.

On approximately 2024-12-30, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Headache, Pruritus. The Headache was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovered'. The Pruritus was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovering'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 7 was calculated, The assessment concluded the relationship was 'Probable'. Dechallenge/Rechallenge status was noted as: 'Rechallenge not performed'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Per western social score.</data>
report_id: ADR-2025-717
report_date: '2025-01-19'
patient_details:
  patient_id: ANON-PX-1847
  gender: Other
  relevant_history:
  - coronary artery disease
  - migraines
  age_at_reaction: 23
suspected_drugs:
- drug_name: Sertraline
  dosage: 327mg
  route_of_administration: Oral
  start_date: '2024-12-26'
  indication_for_use: Major depressive disorder
  drug_class: SSRI
  end_date: '2025-01-16'
adverse_reactions:
- symptom_name: Headache
  onset_date: '2024-12-30'
  severity: Moderate
  outcome: Recovered
  intervention_required: false
- symptom_name: Pruritus
  onset_date: '2024-12-30'
  severity: Mild
  outcome: Recovering
  intervention_required: false
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Rechallenge not performed
  naranjo_score: 7
reporting_facility: Wilkerson, Hale and Smith Medical Center
reporter_type: Pharmacist
notes: Per western social score.
