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Its ability to preserve mitochondrial integrity, enhance cerebral perfusion, mitigate oxidative stress, and support synaptic plasticity positions it as a neuroprotective adjunct rather than a primary monoaminergic antidepressant

Cheng and Kane, 2013

Specifically, increased expression of AMPA receptors in hypoxic white matter sensitizes microglia to glutamate, leading to a regulatory response that reduces protective IGF-1 release, while increasing the release of inflammatory mediators (Sivakumar et al., 2010)