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Warning signs that should prompt immediate medical attention include: New or worsening depression, anxiety, or mood swings Thoughts of self-harm or suicide Significant changes in sleep patterns or energy levels Social withdrawal or loss of interest in previously enjoyed activities Increased irritability, agitation, or restlessness Feelings of hopelessness or worthlessness Difficulty concentrating or making decisions Clinicians should establish baseline mental health status before initiating therapy and conduct regular assessments during treatment, consistent with American Diabetes Association Standards of Care recommendations for psychosocial assessment

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Clinical Pharmacology: Advances and Applications, Volume 14, 6167