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enthusiasm dramatically outpaces science FDA Category 2 classifications for peptides like Semax reflect absence of FDA-standard evidence, not documented harmsRussian clinical experience suggests reasonable safety, but long-term effects by Western standards remain uncharacterized Established interventionsexercise, Mediterranean diet, sleep optimization, cardiovascular risk management, cognitive engagementhave far more consistent evidence than any peptide for dementia risk reduction For Research Prioritization Compounds meriting continued investigation: GLP-1 Agonists: Prevention trials in preclinical/presymptomatic populations, testing compounds with better brain penetration (dulaglutide, lixisenatide) SS-31/Elamipretide: Cognitive outcomes in mitochondrial disease populations, potential expansion to brain aging indications P21: Phase I human trials to establish safety, pharmacokinetics, and proof-of-mechanism for CNTF-pathway neurogenesis Klotho: Watch for Phase 1 results from Jocasta Neuroscience (expected 2027-2028)

2012 Dec;50(10):875-85

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It is shallow, so the needle only travels a short distance, and it has fewer pain-sensitive nerves than deeper tissue, so most people feel a small pinch rather than a deep ache