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TL;DR Zepbound (tirzepatide) and Trulicity (dulaglutide) are both manufactured by Eli Lilly but serve different primary purposes

Heavier, longer, or more frequent periods: Likely mechanism: estrogen release from adipose tissue Typical timeline: starts week 2 to 6, peaks around week 8 to 12, resolves by week 20 to 24 Associated findings: weight loss exceeding 1.5% per week, reduction in waist circumference What it means: your body is releasing stored estrogen faster than your liver can clear it Management: usually self-limiting

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Valproate-induced hyperammonemic encephalopathy in the presence of topiramate