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For instance, in preclinical models, long-term ketamine exposure increases the expression of GABA receptor subunits in the prefrontal cortex while simultaneously reducing glutamate receptor subunits, impairing synaptic signaling and cognitive function ( Ketamine also downregulates brain-derived neurotrophic factor, particularly in the hippocampus, exacerbating deficits in synaptic plasticity and cognitive functions

Clinicians who were reluctant to initiate HRT during the post-WHI era are now prescribing with more confidence, and patients are actively requesting it