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Delays in treatment following overdose are associated with increased mortality

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This energy dysfunction is thought to be due to a compromised tricarboxylic acid cycle enzyme, -ketoglutarate dehydrogenase activity, limited anaplerotic flux and capacity of astrocytes to detoxify ammonium by glutamine synthesis, increased lactate synthesis as well as mitochondrial permeability transition induced by oxidative/nitrosative stress [34, 35]