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APAPGSH conjugates are formed via Michael addition to a NAPQI 2,3-carboncarbon double bond, while a portion of the reactant is reduced back to APAP via the reaction of GSH to the imine double bond [110]

As indicated in the Fumarate Hydratase Mutations section above, accumulation of fumarate in the cytosol leads to inhibition of 2-oxoglutarate and Fe 2+ -dependent dioxygenases and to the post-translational modification of numerous proteins

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doi: 10.1080/07373937.2019.1653906 93

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The extent to which SSRI-TCA interactions may pose clinical problems will depend on the degree of inhibition and the pharmacokinetics of the SSRI involved