It's typically when mold grows in areas with high protein content or specific building materials
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The risk is greater with longer duration of use (251)(252)
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Since norfluoxetine is an active metabolite, such association may impact the response of patients to take fluoxetine as well as implications with increased half-life of this molecule, which is already long, for example, by drug bioaccumulation and the ability to induce serotonin syndromes
doi:10.1038/s41598-018-32100-2 Centers for Disease Control and Prevention (CDC)