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The efficacy estimand includes only patients who stuck with the study protocol completely until the end of the study

Qsymia side effects Common side effects include: Tingling hands and feet Dizziness Altered sense of taste Insomnia Constipation Dry mouth Serious side effects include: Certain birth defects (cleft lip and cleft palate) Faster heart rate Suicidal thoughts or actions Eye problems that could lead to permanent vision loss if not treated Women who might become pregnant should get a pregnancy test before taking Qsymia and should use birth control and get monthly pregnancy tests while on the drug

Even modest reductions in micronutrient availability may therefore influence catalytic velocity across interconnected metabolic pathways, potentially amplifying bioenergetic and redox constraints under chronic flux limitation [112, 113]

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