Tirzepatide is administered as a once-weekly subcutaneous injection, with dosing typically initiated at 2.5 mg and gradually titrated upward (5 mg, 7.5 mg, 10 mg, 12.5 mg, to a maximum of 15 mg) based on therapeutic response and tolerability
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At this stage, it is more accurate to describe these psychological and QoL improvements as concomitant effects of metabolic and symptomatic relief rather than independent psychopharmacological actions
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These mechanisms further activate the hypothalamic-pituitary-adrenal axis, hepatic glycogenolysis, hyperglycemia, hyperlipidemia, and insulin resistance, contributing to core depressive features of anhedonia, emotional dysregulation, and cognitive slowing ( The complex etiopathogenesis of T2DM has been explored in detail and includes insulin resistance (in the liver, muscles, and adipose tissue), impaired insulin secretion, -cell dysfunction, immune dysregulation and meta-inflammation, hyperglucagonemia, disrupted gut microbiota, increased gastric glucose absorption, renal adaptation with enhanced glucose reabsorption and gluconeogenesis, decreased dopamine, and heightened sympathetic tone in the brain ( via cells of the circumventricular organs located around the third and fourth brain ventricles, transmitting signals to deeper brain structures
