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Cycle length is typically 4 to 8 weeks, with a clinical review at the midpoint to assess response

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Concurrently, altered glucose metabolism in the orbitofrontal cortex and limbic regions reflects energy deficits and mitochondrial dysfunction, contributing to the severity of psychiatric symptoms, such as paranoia, agitation, and mood disturbances ( MRI studies have further identified gray matter atrophy in the prefrontal cortex, medial cingulate gyrus, and hippocampus, regions that are critically involved in memory, decision-making, and emotional regulation (Thompson et al., 2004)