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More serious but less common adverse effects include acute pancreatitis (seek urgent medical attention for severe, persistent abdominal pain), gallbladder disease, and risk of dehydration or acute kidney injury from prolonged vomiting Hypoglycaemia risk : When combined with insulin or sulfonylureas, GLP-1 receptor agonists increase the risk of hypoglycaemia [1] Long-term safety : The extended safety profile in older populations and those with established dementia requires further investigation Patients should report suspected side effects via the MHRA Yellow Card Scheme and discuss both the established benefits for metabolic health and the investigational nature of any cognitive effects with their healthcare provider

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A two-way interaction between GSH and glutamate may serve to counteract both glutamatergic deficit and excess in early stages