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It is generally believed (though not established in controlled trials) that treating such an episode with an antidepressant alone may increase the likelihood of precipitation of a mixed/manic episode in patients at risk for bipolar disorder
doi:10.1038/newbio243085a0
It reduces depressive and anxious behavior by suppressing neuroinflammation in mice under stress (61)
There is also a possibility the medication may be contaminated, adulterated or altered, which could cause adverse reactions or unintended effects in patients
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Mounjaro already lowers blood sugar by helping your pancreas release insulin and reducing glucagon
