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3-month cycle structure: Clinical practice follows a loading phase, a maintenance phase, and a rest period before repeating

Together, excessive and reduced production of neuro-toxic and -protective kynurenines, respectively, may exacerbate excitotoxicity and neuroinflammation, establishing a feed-forward cycle of KP dysregulation, 5-HT depletion, HPA axis hyperactivity, and increased vulnerability to MDD

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Again, this likely reflects lower systemic drug exposure rather than a genuine safety advantage of the oral route