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Do not stop topiramate abruptly

In humans, the density of GLP-1 and PYY positive cells increase steadily along the small intestine, decreasing in the colon, and then raising again reaching a maximum density in the rectum with the highest values of around 150 GLP-1-expressing cells per square millimeter

To summarize several meta-analyses of CVOTs conducted with GLP-1RAs, it isconfirmed that based on 43 trials, GLP-1RAs are a class of efficacious agent for reducing MACE (MH-OR 0.87 [0.83, 0.92]), cardiovascular and all-cause mortality (MH-OR 0.89 [0.83, 0.96]) [48]

Summary: There is no official recommendation for routine vitamin supplementation for all GLP-1 users

& Bloom, S