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The mainstream pharmaceutical approach, exemplified by tirzepatide and bremelanotide, emphasizes rigorous FDA approval pathways, large-scale randomized controlled trials, and treatment of specific age-related diseases ( In contrast, the longevity medicine approach, prevalent in anti-aging clinics and compounding pharmacy networks, views aging itself as a modifiable process amenable to intervention ( A third perspective emerges from Russian gerontological research, which has developed and clinically used peptides such as epitalon and Semax for decades with apparent success ( 7.2 Controversies and safety considerations The peptide landscape in gerontology is fraught with controversy