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View Selank Nasal Spray In SURMOUNT-1 (Jastreboff et al., New England Journal of Medicine, 2022), the largest trial in the obesity population (N = 2,539 over 72 weeks): Psychiatric adverse events overall: 5 to 7% across treatment arms, similar to placebo Anxiety specifically: not flagged as a notable adverse event Depression: not flagged as a notable adverse event Suicidal ideation: rare, not significantly different from placebo The most common adverse events in the trials were gastrointestinal: nausea, diarrhea, vomiting, constipation
it must involve nurturing the internal environment of the gut