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The combination can precipitate severe hyperthermia, muscle rigidity, and even death, so clinicians will avoid MB in patients on serotonergic psychiatric medications (or will stop those medications well in advance of giving MB if its needed emergently)

Scholz, J

PMID 9111998

Homocysteine would also contribute to the LDL oxidative modifications mediated by endothelial cells, macrophages, and smooth muscle cells (Heinecke et al, 1987

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