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The regulation of key enzyme activities by natural plant polysaccharides can contribute to the modulation and equilibrium of metabolites with specific neuroactive properties, thereby promoting TRP metabolism to 5-HT while inhibiting TRP metabolism to 3-HK ( Intervention with Polygonatum sibiricum polysaccharides (PSP) was found to downregulate TRP and 3-HK levels in the hippocampus of mice in a behavioral despair model (Wei et al., 2022)

(121) (see Table 15, 16)

The goal is to help patients remain on an effective therapy long enough to achieve sustained metabolic and cardiovascular benefit without unnecessary interruption

Large-scale, long-term follow-up (including open-label extensions and real-world registries) is needed to monitor rebound weight gain after stopping therapy, as early reports suggest weight tends to increase once medication is discontinued (43)