Positives

• Patients with moderate depression describe meaningful improvement in mood and cognition, consistent with the subgroup that benefited most in the Phase 2 data.
  
  
• One patient reported steady week-over-week gains in motivation and clarity at the lower dose range.
  
  

Negatives

• Patients with severe depression frequently report disappointing results, mirroring the trial finding that benefit shrank in that subgroup.
  
  
• A patient reported the primary endpoint failure in the original Phase 2 trial as a reason they did not continue past a few weeks.
  
  

Hurdles & Side Effects

• NSI-189 (now amdiglurax/ALTO-100) is not approved and remains in clinical development under a sponsor; consumer access is grey-market.
  
  
• Patients describe inconsistent vendor quality and no standardized dosing guidance outside the trial setting.