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This abrupt awakening can occur even after severe poisoning and can make airway management more difficult

The report recognizes the polygenic and multifactorial nature of antidepressant response, proposing that other pharmacodynamic genes (e.g., SLC6A4, HTR2A, ADRA2A) may interact with CYP-mediated pharmacokinetics to shape overall efficacy (van Westrhenen et al., 2020)