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Sabiston textbook of surgery: the biological basis of modern surgical practice

The mechanism appears to involve increased serotonin synthesis in substantia nigra (both compacta and reticulata), a regional pattern unlike any existing antidepressant drug, plus potential dopaminergic contributions given the nigrostriatal location

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This is why TRT causes testicular atrophy and reduces sperm production the testes get the signal to downregulate
