Mechanistically, it is described as a monoamine reuptake inhibitor, affecting: Dopamine Norepinephrine Serotonin In weight-management trials, its primary investigational role involved: Appetite regulation Reduced caloric intake Altered reward-driven feeding behavior It is not a GLP-1 analog and does not function via incretin pathways
Cocaine and amphetamines (stimulants) All animal studies retrieved for stimulants misuse involved exendin-4 among GLP-1RAs and highlighted a reduction of cocaine and amphetamines intake and end effects (for example, increased locomotor activity) via modulation of dopaminergic transmission in areas including the nucleus accumbens and the ventral tegmental area 91,92,93,94,96,97,98,99,100,101,102,103,105 , as well as modulation of inflammatory mechanisms 104
When B12 levels are equivocal, additional testing with methylmalonic acid (MMA) and homocysteine levels can provide greater diagnostic accuracy, as both are elevated in true B12 deficiency
There are other FDA-approved oral weight-loss medications available through a prescription, like phentermine, Contrave , and Qsymia