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Cognitive issues like mood changes and "brain fog" from the topiramate component warrant careful consideration, especially for pregnant women due to serious birth defect warnings

Patients who dispensed a GLP-1 RA for the first time within that same period had a run-in period of 12 months and were defined as incident patients, thus excluding patients who dispensed a GLP-1 RA in 2018 when assessing incidence in 2019

Any frequent or unexpected changes in blood glucose levels should be reviewed by a clinician to ensure treatment remains safe and effective

It also modulates the nitric-oxide system, promoting nitric-oxide production in a dose-dependent way and countering agents that block the pathway [5]