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These enzymes may include: cytochrome P450 2D6 (CYP2D6) and CYP3A (that are known to be involved in MDMA metabolism), NADPH-oxidase, xanthine oxidase, and inducible nitric oxide synthase [45]

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174, 175 In the absence of placebo controls, it is difficult to know the size of the true treatment effect and the precise balance between benefits and risks/burdens