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Antidepressants with high serotonergic affinity may present with a clinical picture resembling serotonin syndrome

Osei SP, Akomaning E, Florut TF, Sodhi M, Lacy BE, Aldhaleei WA, et al

In one of these studies, older (~67 years), type 2 diabetics, supplemented with 250 mL of beetroot juice (nitrate: 7.5 mmol) for 14 days, experienced a significant improvement in simple reaction time compared to a control group [5]

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The honest answer is that the human safety data is limited compared to decades-old pharmaceuticals, but the preclinical safety record across multiple species is unusually clean for a peptide with this level of biological activity