Significant comorbidities, like type 2 diabetes or sleep apnea, that dont fully resolve with medication-driven weight loss alone
It mitigated oxidative stress by reducing MDA and ROS while increasing SOD activity and GSH production, effectively alleviating anxiety-like behaviors in mice [60]
Combined with potential GI side effects, this may lead to fluid and electrolyte loss, making intentional hydration more important
Most studies were of the case control design, however, additionally there were two double blinded [64, 65] and one open labelled randomised controlled trial [49], a case series [66] and a case report [54]
Prospective studies enrolling youth with baseline depressive disorders are needed to determine symptom trajectories using goldstandard measures (e.g., Children's Depression Rating ScaleRevised)
While increasing the dose too quickly can cause side effects like nausea, taking too little may reduce results