va glp-1 website says this about medications : r/VeteransBenefits VAResearchNewsBrief: Researchers from @OVAHCS and

The concerted efforts of synthetic chemists over the years have led to a common understating that organo-selenium compounds depending on their chemical structure can mimic GPx-like activity [71,72,73]

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Why breakouts happen: Primarily due to "purging" (toxin release), hormonal shifts, or sensitivity to specific formulations

Considering Alternatives For individuals experiencing intolerable side effects or for whom fluoxetine is ineffective, discussing alternative medications or therapies with a healthcare provider is essential