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Later, in a population with bipolar depression and insulin resistance, a proof-of-concept open-label trial found that adjunctive pioglitazone (1545 mg/day for 12 weeks) was associated with significant improvement in depressive symptoms, measured primarily with the Hamilton Depression Rating Scale (HAM-D), as well as improvements in metabolic parameters [55]

Acyl Group : A fatty acid chain of varying lengths (short, medium, or long) attached to the hydroxyl group of carnitine via an ester bond

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