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For musculoskeletal indications, most patients at our Doral clinic report a noticeable reduction in pain within 2 to 3 weeks and a functional improvement (range of motion, strength, load tolerance) by weeks 4 to 8

Cognitive behavioral therapy Drug therapy First-line antidepressants: selective serotonin reuptake inhibitors (SSRIs) eg, fluoxetine (Prozac) and citalopram (Celexa), serotonin-norepinephrine reuptake inhibitors (SNRIs) eg, duloxetine (Cymbalta) and venlafaxine (Effexor), and atypical antidepressants eg, bupropion (Wellbutrin) and mirtazapine (Remeron) Second-line antidepressants, including: tricyclic antidepressants eg, amitriptyline (Elavil) and clomipramine (Anafranil) monoamine oxidase inhibitors (MAOIs) eg, tranylcypromine (Parnate) and phenelzine (Nardil) Atypical antipsychotics: eg, aripiprazole (Abilify) and quetiapine (Seroquel) Neurostimulation techniques Electroconvulsive therapy Vagus nerve stimulation Repetitive transcranial magnetic stimulation Ablative neurosurgery What are Some Emerging Treatments for Depressive Disorders

Reference: Chang CH, Tsai WC, Lin MS, Hsu YH, Pang JHS

Five Core Biological Actions The 2015 and 2018 Pickart and Margolina reviews catalog the biological actions of GHK-Cu across in vitro, animal, and human studies 1 2

Their activity in mitophagy is regulated by phosphorylation: The phosphorylation of BNIP3 at Ser17 and Ser24 within its LIR motif is essential for LC3B interaction (86), while the phosphorylation of NIX at Ser34 and Ser35 enables it to bind with GABARAP family proteins (87)

Interestingly, a recent study examining the time-dependent effect of low IGF-1 levels on aging outcomes observed that a targeted reduction in liver-derived IGF-1 early (10 d or 5 mo) or later in life (15 mo) improved aspects of lifespan in females, though these effects were most pronounced when IGF-1 was reduced at 5 mo old 19