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doi: 10.1016/j.ypmed.2016.10.019 38

Cotinine was associated to continuous assessments of In a survey, hyperactive behavior was measured using a dimensional scale rather than a diagnostic scale [9, 34] In addition to serum lead levels and other common control variables, researchers discovered a substantial inverse connection between urine cotinine levels and neurocognitive performance assessments

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This suggests that sertraline has a role in managing depressive symptoms that could contribute to relapse, according to Gual A et al