I’ve been on teriparatide (Forteo) after a bad experience with Prolia, so I’ll just share my experience. First off, your fear is completely understandable given the ONJ + rebound loss — that’s a serious situation. For Forteo, most side effects (if they happen) are usually early and physical: mild dizziness after injection, occasional nausea, or muscle cramps. For me, it mostly settled within the first couple of weeks. On depression and insomnia — they’re listed, but in real-world experience they don’t seem to be common or persistent issues. I was also worried about that, but didn’t notice any meaningful mood or sleep changes. The big difference is that Forteo actually builds bone, which is why it’s often used in severe cases like a -3.6 spine T-score or after Prolia complications. It’s also not associated with osteonecrosis of the jaw. Practical tip: a lot of people take it at night and just sleep through any initial lightheadedness. Overall, it’s one of the main “rebuilding” options doctors use after Prolia-related problems, but it’s still totally valid to be cautious given your history.