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The greater decrease in LAC levels in severe forms of MDD and in patients with treatment resistant depression (TRD) is akin to a kindling-like progression of depression in that earlier age at onset and/or the presence of early life adversity, such as emotional trauma, conveys liability to more severe and treatment-resistant course of illness [51, 53, 55]

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Equilibrium constants of the reactions of choline acetyltransferase, carnitine acetyltransferase, and acetylcholinesterase under physiological conditions