The exact incidence remains lowtypically less than 2% of usersbut individual cases do surface
However, tirzepatide differs from the other medications in that it is a dual-action GLP-1 (short for glucagon-like peptide 1) and GIP (short for glucose-dependent insulinotropic polypeptide) medication
The mixture is swirled in a gentle manner
This centrally produced GLP-1 reaches specific receptors located in key structures involved in appetite regulation, such as the paraventricular nucleus, the lateral septum, the nucleus accumbens and the lateral parabrachial nucleus.2,3,6 Furthermore, it promotes aversive responses, inhibits neuroinflammation and gastric emptying, and stimulates sympathetic tone and thermogenesis in experimental models.2,4,6 Activation of GLP-1R on neurons in the arcuate nucleus stimulates the production of pro-opiomelanocortin (POMC), which in turn inhibits neurons that produce neuropeptide Y (NPY), thereby generating an appetite-suppressing response.2 GLP-1 production has also been reported in the olfactory bulb, although its significance remains unclear.2,6 GLP-1R has been identified in the sinoatrial node, atrial and ventricular myocytes, and vascular endothelium

Cell Calcium 47(2):165174 Wang Y, Wang W, Li D, Li M, Wang P, Wen J, Liang M, Su B, Yin Y (2014) IGF-1 Alleviates NMDA-induced excitotoxicity in cultured hippocampal neurons against autophagy via the NR2B/PI3K-AKT-mTOR pathway