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It is a coordinated disruption in both hormonal signaling and cellular energy regulation, operating simultaneously across the brain, adipose tissue, vasculature, and metabolic systems
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and naltrexonebupropion (Mysimba), which requires particular caution because fluoxetine is a potent inhibitor of the liver enzyme CYP2D6 and can increase bupropion levels, raising the risk of seizures and neuropsychiatric effects
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