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Baclofen and benzodiazepines can interact with other medications, which may increase side effects or reduce effectiveness

This is the same principle behind why recombinant protein biologics (monoclonal antibodies, insulin analogues) are never shaken: air-water interfacial agitation unfolds polypeptide chains that then reassemble into non-native oligomers or fibrils

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Additionally, the presence of publication bias suggested by Eggers test and funnel plot asymmetry indicates that smaller studies with non-significant results might be underrepresented