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We're not talking about eating blueberries
While there is no proof of a causal association, experts say the risks are significant enough that awareness is important as part of a precautionary approach
My general framework: Start with semaglutide if cost is a significant concern, or if there is no strong reason to expect poor tolerance Start with tirzepatide if the patient has tried semaglutide before and struggled with side effects, if faster initial response matters clinically, or if the patients goals require larger total weight loss Switch to tirzepatide if a patient on semaglutide is experiencing persistent nausea or has plateaued and escalation options are limited One pattern worth noting: men I see a consistent pattern with male patients who struggle to tolerate semaglutide nausea and GI disruption can be particularly disruptive for them, and theyre often less willing to push through it
In this sense celecoxib showed to be a safe and a highly effective therapeutical option in resistant bipolar depression, reducing anxiety and accelerating treatment response [335], in a similar way to aspirin [336]
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