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Titration: There is generally no need for upward titration with B-complex vitamins as one might do with certain drugs, but if a patient is frail or known to react to injections, the provider may choose to start at a lower dose (for example 0.25-0.5 mL) and then increase to 1 mL as tolerated

In an animal model of depression and diabetes, however, exendin-4 led to antidepressant-like effects, which was associated with changes in microglial function 168

However, this finding must be interpreted with caution due to pre-existing gingival pigmentation and potential confounding factors, including smoking and sunbed use

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Maintain consistent weekly timing