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The triple agonist mechanism means appetite suppression builds differently than with dual agonists alone
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For example, in hypovolemic or euvolemic states where vasopressin levels are elevated, the ability of D 2 -like receptor agonists, probably exerted at the D 4 R to inhibit the effects of vasopressin (426, 599), may obscure the stimulatory effect of D 2 -like receptors on water and ion transport in more proximal parts of the nephron
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