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Severe nausea or vomiting may lead to inadequate nutrient intake and malnutrition

When Combination Therapy Should Not Be Used Using both medicines together may not be appropriate if: The patient has kidney stones, severe depression, eating disorders, or glaucoma (Topiramate concerns) The patient has a history of pancreatitis, severe gastrointestinal disease, or certain thyroid conditions (semaglutide concerns) The person is pregnant or planning pregnancy Side effects become too strong when both medicines are used The patient cannot attend regular follow-up appointments In these cases, a single medication or a different treatment plan may be safer

Some patients may require an even higher dose of 2 mg weekly for optimal effect, particularly for weight management indications, though this should be approached cautiously with careful monitoring for adverse effects

Imbriani P, Martella G, Bonsi P, Pisani A (2022) Oxidative stress and synaptic dysfunction in rodent models of Parkinsons disease