Taking omega-3s at a separate time of day than isotretinoin is a reasonable precaution, but there is no controlled trial demonstrating that co-administration produces clinically dangerous plasma peaks
Hepatic encephalopathy is a required feature of the syndrome, and manifestations may range from subtle mental status changes, such as difficulty with concentration, to coma (Table 23.5)
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Less melatonin means weaker circadian signals
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