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The authors hypothesized that this was due to trimetazidine affecting the brain tissue cell metabolism, and potentially transporting serotonin from brain tissue into the peripheral nervous system

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Early data suggests it does

The protein carnitine-acylcarnitine translocase, also known as solute carrier family 25 member 20 (SLC25A20), is an important component of the inner mitochondrial membrane and is essential for the transport of acylcarnitine into the mitochondrial matrix (4)