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Initially, the symptoms involve dysarthria, ataxia, and gross tremor, which may go to nausea, vomiting, abdominal pain, dry mouth, profuse diarrhea, lethargy or excitement, vertigo, alteration in the level of consciousness, cardiac arrhythmias, muscle fasciculations, hyperreflexia, delirium, nystagmus, convulsions, oliguria, and anuria [77]

Think of the peptide as a key and the receptor as a lock: constant use wears the mechanism, and a planned off period lets it resensitize

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Post-marketing surveillance through the FDA Adverse Event Reporting System (FAERS) and clinical experience suggest that some patients do report sleep changes after starting tirzepatide

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