Suicidal thoughts or behaviors Seizures (from withdrawal) Vision problems: blurred vision, loss of vision, double vision, blind spots Serious bleeds: bleeding thats difficult to stop, vomiting blood, blood in the urine or stool, coffee-ground stool Severe skin reactions: rash, skin pain or peeling, blisters, fever, sore throat, extreme tiredness, swelling of the face, swollen lips Extreme drop in body temperature: shivering, feeling tired, feeling confused, slurred speech, coma Dangerously high body temperature: fever, headache, dizziness, feeling confused, nausea, vomiting muscle cramps, skin thats very warm or hot to the touch Dangerously high blood acid levels: feeling very tired, breathing very fast, poor appetite, irregular heartbeat, trouble thinking clearly, sharp pain near the side and back from kidney stones Extremely high blood ammonia levels: fatigue, poor mental alertness, vomiting Effects of other drugs, drug classes and over-the-counter products on Topamax The following medications may interact with Topamax: Contraceptives: decreased contraceptive efficacy and increased breakthrough bleeding, especially at doses greater than 200 mg/day Monitor lithium levels if lithium is used with high-dose Topamax Who makes Topamax

Either way, the message gets delivered just with some difference in timing
Tirzepatide is a newer, more complex molecule (dual GIP/GLP-1 agonist vs
four compounds with complementary healing and anti-inflammatory mechanisms targeting tissue repair, gut healing, collagen synthesis, and cytokine modulation