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This release of bile acids, mainly cholic (CA) and chenodeoxycholic (CDCA) acid derivatives, happens through the relaxation of the smooth muscle sphincter upon CCK signaling (336) or indirectly through a similar VIP action on the sphincter of Oddi (337)
However, the included trials were conducted on relatively small sample sizes, which may limit the ability to detect rare psychiatric outcomes
While commercially available options like Wegovy and Ozempic are effective, compounded semaglutide offers the flexibility to adjust dosages and formulations to meet individual requirements
Only about 17% of patients under 10 years of age are found to have neuropsychiatric symptoms at presentation, whereas in patients presenting after 18 years of age, 74% experience neurologic manifestations.2,20 It is usually after 10 years of age that patients may manifest evidence of involvement of the other organ systems such as renal, hematologic, and endocrine (Figure 252)