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Given that, the sensible position is to treat the drug-interaction contraindications as firm, particularly antidepressants and stimulants, while accepting that for someone on no such medications the risk is likely small but genuinely unquantified

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The increase in vitamin B12 levels in non-responders was significant but much lower than the increase in levels among the responders

However, human clinical evidence is still limited, and larger, well-controlled trials are needed to clarify safety, efficacy, and appropriate use