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It is knowing which patient needs a GLP-1 and which one needs a workup, how to titrate through the nausea window without losing the patient, how to protect lean mass during rapid loss, how to screen for the contraindications that matter, and how to tell a patient honestly what an adjunct will and will not do for them

Fosphenytoin may not be preferred for the following reasons : [i] Fosphenytoin has a similar mechanism to that of lacosamide (both are sodium-channel blockers)

Cognitive Difficulties : Memory loss, confusion, and trouble focusing

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Your doctor will make the call based on your situation and how you respond to the initial treatment