title: Managing patients who are ultra-rapid metabolisers of antidepressant medications.
abstract: OBJECTIVE
  The objective of this study was to increase recognition of ultra-rapid metabolising status as a cause of treatment-resistant depression and consider management options.
  
  
  CONCLUSIONS
  The incidence of ultra-rapid metabolising status is not rare in patients who fail to report improvement with antidepressant medication. Two broad options are available for identifying ultra-metabolising status. While there are several management options available to the clinician, combination therapy is likely of low utility while there are risks associated with mega-prescribing. As the literature is limited, clinician observations about alternate strategies would be welcomed.
authors.affiliation: Scientia Professor, School of Psychiatry, University of New South Wales, Sydney, NSW, and; Professorial Fellow, Black Dog Institute, Prince of Wales Hospital, Randwick, NSW, Australia g.parker@unsw.edu.au.
authors.forename: Gordon
authors.initials: G
authors.lastname: Parker
mesh_terms: D000928:Antidepressive Agents / Q000378:metabolism* / Q000627:therapeutic use*; D061218:Depressive Disorder, Treatment-Resistant / Q000188:drug therapy*; D019468:Disease Management; D004359:Drug Therapy, Combination; D006801:Humans; D017211:Treatment Failure
chemical_list: D000928:Antidepressive Agents
keywords: genotyping; treatment-resistant depression; ultra-rapid metabolising status