{"Based on the genotype result, this patient is predicted to be a CYP2C19 poor metabolizer and is at risk for higher plasma concentrations and increased probability of side effects with standard dosing. Consider a clinically appropriate antidepressant not predominantly metabolized by CYP2C19. If citalopram is clinically appropriate, consider a lower starting dose, slower titration schedule and 50% reduction of the standard maintenance dose. Please consult a clinical pharmacist for more information."}