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HF-TMS over the left DLPFC is shown to have a superior effectiveness compared to sham treatment in individuals with depression even when used without concomitant antidepressant (118, 119), and has the benefit of accelerating clinical response (120) and also effective as a monotherapy for both unipolar or bipolar depression (121)

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peaks during dose escalation, typically mild-moderate Diarrhea -- 10-20%, usually transient Constipation -- 8-15% Vomiting -- 5-15%, more frequent at higher doses Injection site reactions -- 5-10%, mild erythema and pruritus Decreased appetite -- 5-12%, related to mechanism of action Pancreatitis -- rare but monitored (as with all GLP-1/amylin agents) Gallbladder events -- cholelithiasis reported, consistent with rapid weight loss Trial data describes dose titration as central to tolerability -- the 16-week escalation protocol substantially reduced GI adverse events