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In patients with alcohol dependence and delirium unresponsive to high doses of benzodiazepines, alcoholic pellagra should be considered, since chronic alcoholism leads to a lack of tryptophan 2,3-dioxygenase, an enzyme linked to niacin synthesis

doi: 10.1111/wrr.12387

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Elevated serum bilirubin levels have been reported in clinical studies with patients treated with milk thistle extract ( Silybum marianum (L.) Gaertn.) via the inhibition of the UGT1A1 activity by flavonolignans from the silymarin complex [111]

C., Hotza, D