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Efficacy and tolerability of oral and intramuscular S-adenosyl-L-methionine 1,4-butanedisulfonate (SAMe) in the treatment of major depression: comparison with imipramine in 2 multicenter studies

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Whilst vitamin B12 toxicity is exceptionally rare due to its water-soluble nature, very high levelsparticularly from mega-dose supplements or frequent injectionshave been associated with certain adverse effects, most notably skin reactions