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However, the absence of formal clinical trials means long-term safety cannot be guaranteed

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Medicines which can decrease the absorption of Vitamin B12 include: Colchicine (a medicine used to treat gout) Metformin (an anti-diabetic agent) Excessive Alcohol Vitamin C products

The mechanism appears to involve increased serotonin synthesis in substantia nigra (both compacta and reticulata), a regional pattern unlike any existing antidepressant drug, plus potential dopaminergic contributions given the nigrostriatal location

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