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In one mechanism, APAP becomes hepatotoxic after its metabolism by CYP2E1 and other P450 isoforms, and produces a reactive metabolite named N -acetyl- p -benzoquinone imine (NAPQI) [110, 271, 272]

(A) Molecular structure of glutathione, (B) the extended, and (C) the folded conformations

TD: Tardive Dyskinesia for total (+) active metabolites for tetrabenazine & deutetrabenazine Schneider et al (2021) Adapted from Diana (2007), Schneider et al (2021) & Cheung & Parmar (2022) Notes on Reserpine & Synaptic vesicles:

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Zinc supplementation offers a promising way to mitigate these effects, as it has been shown to reduce symptoms of inflammaging and lower IL-1 release