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Placebo-controlled trials are critical to demonstrate that the drug is effective and safe and not just better than nothing

Yes, fatigue or tiredness can sometimes occur, although its less common than gastrointestinal side effects like nausea or diarrhea

Some individuals find that adjusting their injection day or time helps minimise any sleep-related effects, though there is no specific evidence supporting one timing over another, and any changes should be discussed with a healthcare provider

It is an elegant solution to a genuinely difficult pharmaceutical problem, and understanding it explains why the taking instructions are so specific