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[] Pharmacologic treatment Includes GDMT depression Tricyclic antidepressants are contraindicated in patients with heart disease because of the higher risk of hypotension, arrhythmia, worsening of HF, and myocardial infarction Depressive symptoms improve with selective serotonin reuptake inhibitors (SSRI)—sertraline and escitalopram—but show no significant benefit over placebo in improving symptoms and outcomes [] Newer modalities of treatment: [] Brain stimulation: Transcranial magnetic stimulation (TMS), a modern brain stimulation technique, is an effective antidepressant monotherapy

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It has recently been demonstrated in neutrophils that lactate can be used as non-glucose substrates to generate glycogen stores (86)