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Its binding to VMAT2 is very strong, making it's effect appear irreversible, with trace amounts of the drug remaining bound to vesicular membranes for many days, and its clinical effects lasting many days to weeks, and may persist until new transporter proteins are synthesized (German et al, 2015
Weight loss plateaus are common and usually temporary
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The clinical trial protocols that showed the best results used treatment cycles with rest periods in between
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