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A 2023 case series in Headache: The Journal of Head and Face Pain (Robbins et al.) reviewed 847 patients starting semaglutide and found: 14% reported headaches during the first 16 weeks Of those, 23% noted clear positional worsening (worse lying down or worse standing, depending on individual CSF dynamics) 89% of positional headaches resolved by week 20 without intervention beyond hydration 2.1% required temporary dose reduction 0.4% discontinued due to intolerable headache The positional component is underreported because patients don't always connect the pattern
In addition to these widely used AOMs, Exenatide, one of the earliest GLP-1 RAs approved by the FDA and EMA for T2DM management, is not indicated for weight management but remains clinically relevant, particularly in older adults with comorbid obesity and T2DM, given its long-term clinical experience and established tolerability profile [26,27,28]
Small peptides like bremelanotide hold out hope for cycle-linked symptoms like low libido and mood dips
Pharmacotherapy of type 2 diabetes: an update
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