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This relationship creates a destructive cycle: stress lowers BDNF, which impairs the hippocampal circuits that regulate stress responses, which leads to more cortisol production and further BDNF reduction

For comparison, semaglutide alone achieved approximately 14.9% in the STEP 1 trial, and tirzepatide achieved approximately 20.9% in SURMOUNT-1 at 72 weeks

J Egypt Natl Canc Inst 34(1):22 Jozefowicz-Korczynska M, Pajor A, Lucas Grzelczyk W (2021) The ototoxicity of antimalarial drugsa state of the art review

Changes in those peptides or in the sensitivity of their receptors can be associated with worse outcomes
