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This is an excellent work that adds to our understanding on how rapid antidepressant therapies work. Although authors discuss on a possible reset of 5-HT1A receptors in terminal areas as a consequence of ECT, could it be possible that decreased 5-HT1A binding in projection areas reflected a response to an increased serotonergic release? Interestingly, this does not seem to occur in the dorsal raphe, which would be beneficial for a rapid antidepressant response inasmuch as 5-HT1A autoreceptors are not stimulated.

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