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This consistent pharmacokinetic profile may not be achieved with individual dextromethorphan and bupropion treatments of similar dosages, especially if bupropion concentration was too low to adequately inhibit cytochrome P450 2D6

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Its recommendation is based on studies that signal mitochondrial dysfunction as part of the pathogenesis of CVS.98,99 Patients with migraine show reduced mitochondrial respiratory complex function, which most likely is present in CVS as well, albeit there are no studies confirming that assumption.100 Coenzyme Q10 (Co-Q10) is a natural hydrophobic compound derived from steroids that acts as an electron transporter between complex 1 or 2 and complex 3 of the mitochondrial respiratory chain