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The difference reflects the pharmacological advantage of a stable, elevated GLP-1 signal

Compounded medications have not been evaluated or approved by the FDA for safety, efficacy, or quality

GLP-1s are also pregnancy-contraindicated but lack topiramates specific teratogenic profile
At the 2025 Heart Rhythm Society annual meeting, Sundaram and colleagues presented the results of the TRANSFORM-AF trial

From 2008-2010, Sanofi-Aventis Acomplia (selective CB1 antagonist) and Abbott Laboratories Meridia (NE/5-HT reuptake inhibitor)--both also designed to suppress appetite--were pulled from the market over similar cardiac safety concerns
