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Refractory anxiety may cause glutamate receptor damage in the hippocampus and neuronal atrophy in the prefrontal cortex (PFC), which can result in mood disturbances and cognitive deficits [205]

Methylxanthines also inhibit phosphodiesterase activity, preventing the breakdown of cAMP and stimulating lipolysis in fat cells (2, 95)

Beside the aforementioned studies, all other domains across the included studies were demonstrated low risk of bias according to the respective assessment tools

2 Overall response: the initial 12 weeks were selected since most nonresponding patients from both arms discontinued FIT-1 and FIT-2 and entered the open-label extension study at or very soon after week 12

matters because combining supplements can change effects, tolerance, and safety monitoring needs

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