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Although as shown by 31 P MRS studies no consistent changes of ATP, phosphocreatine and P i can be identified from frontal lobe, temporal lobe and subcortical regions [60], interestingly the reaction rate of creatine kinase, the enzyme catalysing the exchange between phosphocreatine and ATP, was decreased in anterior cingulate cortex of patients using magnetization transfer experiment in 31 P MRS [61]
Many patients have taken these medications for years, often at higher doses, and new concerns are emerging about chronic gastrointestinal, neurological, pancreatic, renal, and hormonal effects
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