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Taking any serotonergic drug: MAOI, SSRI, SNRI, tricyclic, triptan, tramadol, tapentadol, meperidine (pethidine), dextromethorphan (most OTC cough syrups), linezolid, methylene blue, St John's wort, 5-HTP or L-tryptophan

Methylcobalamin is the bioactive form of vitamin B12, meaning it doesn't require the liver conversion step

However, the lasting effects of these injections can vary significantly between individuals, influenced by factors such as overall health, the severity of the deficiency, and the bodys absorption capacity