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The mechanism by which GLP-1 RAs potentially increase suicide or suicide attempts is unclear but may involve an overactivation of the hypothalamic-pituitary-adrenal (HPA) axis [7], rapid weight loss [8], and reduced expression of brain-derived neurotrophic factor which may link weight changes to heightened anxiety and suicidal risk [9]

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Patients who remain on therapy for 36 months often report that their baseline reflux is better than before they started, despite the rough early period
