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head CT scan Potential indications may include: Possible head trauma with risk for intracranial hemorrhage Clinical concern regarding cerebral edema general supportive measures general supportive measures Intubation may be needed for airway control

This is likely due to Tirzepatide targeting both the GLP-1 & the GLP-1RA, while Semaglutide only targets the GLP-1 receptor

Abbreviations PD: Parkinsons disease NAC: N-acetylcysteine GSH: Glutathione GSSG: Glutathione disulfide UPDRS: Unified Parkinsons Disease Rating Scale CSF: Cerebrospinal fluid DAT: Dopamine transporter MRS: Magnetic resonance spectroscopy MPP: 1-methyl-4-phenylpyridinium MPTP: 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine ADL: Activities of daily living MoCA: Montreal cognitive assessment 4-HNE: 4-hydroxynonenal 6-OHDA: 6-hydroxydopamine L-DOPA: Levodopa ECG: Electrocardiogram SPECT: Single-photon emission computed tomography PROMIS: Patient-reported outcomes measurement information system PDQ-39: Parkinsons Disease Questionnaire-39 PRO-PD: Patient-reported outcomes in Parkinsons disease H&Y: Hoehn and Yahr MMSE: Mini-mental state examination CBC: Complete blood count ALT: Alanine aminotransferase AST: Aspartate aminotransferase BUN: Blood urea nitrogen SOD: Superoxide dismutase MCID: Minimal clinically important difference SD: Standard deviation References Ball N, Teo W-P, Chandra S, Chapman J (2019) Parkinsons disease and the environment

METAOD clinical program (Phases I, II, IIb)