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Understand the risks: Switching medications requires careful consideration of potential side effects and interactions

The FDA ended this practice in March 2025 after confirming that the shortage was resolved, citing safety concerns about unregulated compounded versions

The constipation effect typically peaks during dose escalation phases and often improves as your body adapts over 4 to 8 weeks

The case underscores the importance of maintaining a high index of suspicion for TBIR in patients with severe insulin resistance, especially when also presenting with cachexia, acanthosis nigricans, preserved C-peptide, or autoimmune serologies, even in young individuals without a prior diagnosis of systemic autoimmune disease

Austin PC (2014) The use of propensity score methods with survival or time-to-event outcomes: reporting measures of effect similar to those used in randomized experiments

However, the topiramate group demonstrated a reduction in visceral adiposity and lower very-low-density lipoprotein cholesterol (VLDL-C) levels, with no adverse effects [91]