In the SURMOUT-1 trial 2,539 patients underwent randomization to tirzepatide or placebo and were followed for 72 weeks demonstrating up to 20.9% weight reduction with maintenance dosing versus 3.1% in the placebo group for a net 17.8% weight reduction [35]
The increase was larger at higher doses, peaked after 24 weeks of treatment, then went down later in the trial
GLP-1R downregulation can diminish the effects of GLP-1 and its analogues on target cells
DRUG INTERACTIONS As with other medications, topiramate can interact with alcohol, marijuana and certain medications, including antiepileptic drugs, CNS depressants, oral contraceptives, lithium, other carbonic anhydrase inhibitors, hydrochlorothiazide, pioglitazone and amitriptyline