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This reflects the difference in the real-world clinical practice where patients who experienced side effects might more easily decide to stop the therapy as they perceived benefits from naltrexone-bupropion outweighed by additional considerations such as cost

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When LDN Alone May Not Be Enough Some patients may experience suboptimal results with LDN alone, due to: Persistent metabolic dysregulation (like insulin resistance) Chronic inflammatory states resistant to LDNs immunomodulatory effects Co-existing conditions such as mild cognitive impairment or mood disorders Limitations with existing medications (like tramadol or other opiates) that excludes from LDN therapy, but not Microdosing GLP-1 In these cases, adding Microdosing GLP-1 may enhance outcomes by addressing metabolic and systemic inflammation more comprehensively

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