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Trimethoprim is metabolized in vitro to 11 different metabolites, of which, five are glutathione adducts and six are oxidative metabolites, including the major metabolites, 1- and 3-oxides and the 3- and 4hydroxy derivatives

Was the outcome clinically meaningful

The synthesis and agglutination of melanin happen due to the reaction of Tyrosinase enzymes and L-DOPA that oxidize your skin to cause melanin synthesis

Symptom improvement is seen in a subset of patients, but the majority show no improvement or worsening of symptoms despite treatment or attack resolution

A pivotal 2009 study published in Neuro Endocrinology Letters by Maes et al