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The Vmes forms a longitudinal column extending from the level of the superior colliculus, sometimes reaching the pretectal area and interstitial nucleus of Cajal, caudally surrounding the cerebral aqueduct and fourth ventricle through the inferior colliculus and locus coeruleus

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Side effects that feel unmanageable in the first few weeks may be very manageable with dietary adjustments, OTC medications, and a modified dose escalation schedule