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The information collection burden associated with this measure is currently approved under OMB control number 0938-1109

Dihydrofolate reductase is a key enzyme in folate metabolism in vivo, responsible for the reduction of dihydrofolate to tetrahydrofolate, which is involved in the methyl shuttle required for the ab initio synthesis of thymidylate and certain amino acids

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155 The approval was based on findings from two phase III, randomized, controlled trials with a combined total of 960 participants with fibromyalgia

Therefore, clinicians must be aware of the possibility of psychiatric symptoms such as those seen in the present case in patients who have undergone total gastrectomy