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These detrimental effects are mediated by complex mechanisms, including direct hepatotoxicity, oxidative stress, immune dysregulation, oncogenic signaling, and systemic metabolic disturbances

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32 Authors of a 12-week RCT (N=68) comparing fluoxetine 40 mg/d with placebo for people with cocaine dependence and major depression found that abstinence from cocaine was significantly lower in the fluoxetine group, with no commensurate benefit on depression