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The guanidyl group of Arg132 helps stabilize the pentavalent transition state that yields the acyl-phosphate intermediate

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A quality multivitamin, additional B vitamins (especially if your formulation does not already include B12), magnesium for constipation management, and omega-3 fatty acids for metabolic health are commonly recommended additions

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J Clin Psychiatry 2026;87(3):26com16484 Submitted: April 17, 2026