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Protocol details: Initial phase dose: 20-30 ml per day Initial phase route: IV infusion (diluted in 100-250 ml saline) Initial duration: 14-21 days Maintenance dose: 10 ml per day Maintenance duration: 14 additional days Infusion time: 30-60 minutes (never rapid bolus at these doses) Expected timeline based on TBI trial data: Day 7-10: Improved neurological scores on GCS Day 21: Favorable GCS in treated patients with contusion and diffuse axonal injury Week 12: Significant cognitive improvement (CASI scores) in mild TBI Month 6: 67% achieved good outcomes (GOS 3-5) in moderate to severe cases Protocol 3: combination approach with donepezil Goal: Maximize cognitive benefit in established dementia through complementary mechanisms
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For most people, this is when the effect transitions from "I think something might be different" to "I am definitely eating less and it requires no effort." By weeks 4-8, particularly as doses reach 4 mg or higher, the appetite effect is typically well established
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