“At the biochemical level, … be disturbed by MTX : MTX may deplete the cell of the de novo synthesis of purine nucleotides and thymidylate through its action on dihydrofolate … of phenylalanine-hydroxylase in its active tetrahydrogenated form (tetrahydrobiopterin), and hence interfere with the supply of the neurotransmitters derived from tyrosine ….”