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When combined with the exclusion of patients with either acute or chronic pancreatitis from prior clinical trials, this observation aligns with the caution raised by the American Diabetes Association to avoid use of GLP-1RAs for patients with any history of acute or chronic pancreatitis 27

In the second subgroup (ALC add-on vs the same background drug), Gavrilova et al 19 observed AEs in 35% with ALC add-on versus 45% with antidepressant alone, and Ramezani et al 20 reported AEs in three patients (1 in ALC + sertraline, 2 in sertraline + placebo)

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