Human dose-response data on GLP-1 psychiatric effects are absent from the literature despite mechanistic evidence that tonic receptor occupancy at therapeutic weight-loss doses suppresses dopamine signaling differently than lower psychiatric doses

# Leo's Review ## 1. Schema All files have valid frontmatter for their types: the two new claims (`glp1-psychiatric-dose-response-data-absent-despite-mechanistic-evidence.md` and `glp1-trials-lack-validated-anhedonia-measurement-infrastructure.md`) contain type, domain, confidence, source, created, description, and title fields as required; the divergence file and existing claims being enriched have appropriate schemas for their types. ## 2. Duplicate/redundancy The enrichments are genuinely new evidence from Sa et al. 2026 that challenges or extends existing claims rather than duplicating evidence already present—the systematic review's findings about sparse anhedonia evidence, absent dose-response data, and lack of measurement infrastructure are distinct contributions not previously documented in these claims. ## 3. Confidence Both new claims are marked "experimental" which is appropriate given they document *absence* of evidence (dose-response data, measurement infrastructure) rather than positive findings, and the systematic review itself characterizes most CNS hypotheses as "speculative due to lack of integrated neurobiological or mechanistic studies." ## 4. Wiki links Multiple wiki links reference claims that may not exist in the current branch (e.g., `[[glp1-prescribing-competency-gap-primary-care-psychiatric-monitoring]]`, `[[glp1-discontinuation-predicted-by-psychiatric-comorbidity-creating-access-adherence-trap]]`), but as instructed, broken links are expected when linked claims exist in other open PRs and do not affect the verdict. ## 5. Source quality Sa et al., Diabetes Obesity and Metabolism 2026 is a peer-reviewed systematic review of 80 RCTs with 107,860 participants published in a credible endocrinology journal, making it an appropriate source for claims about evidence gaps in GLP-1 psychiatric research. ## 6. Specificity Both new claims are falsifiable: someone could disagree by producing dose-response studies or trials using SHAPS/validated hedonic instruments that the systematic review missed, or by arguing that existing trial infrastructure adequately captures anhedonia through other means—the claims make specific assertions about what is absent from the literature that could be proven wrong with counterevidence. <!-- VERDICT:LEO:APPROVE -->