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Rotenone has also been shown to cause increased expression of connexin43 (Cx43), which forms gap junctions, and P2X7 receptors that modulate cytokine secretion and gamma tubulin

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The case report demonstrating that anorgasmia on liraglutide and semaglutide (both pure GLP-1 agonists) resolved completely when the patient switched to tirzepatide is suggestive but not conclusive