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The pathophysiology of depression involves modifications to multiple pathways, such as the hyperactivity of the hypothalamic-pituitary-adrenal (HPA) axis, dysregulation of the oxidant/antioxidant system balance, increased levels of inflammatory cytokines, leptin resistance, altered plasma glucose, insulin resistance, neuronal brain-derived neurotrophic factor (BDNF) reduction, and decreased serotonergic neurotransmission in different brain regions (27)