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Some kits include metformin and bupropion naltrexone instead, combined with topiramate and vitamin B12
The images of them in NHS scrubs are synthetic
10.1186/s12885-025-14299-2 56 HuQ.ZhangL.TaoY.XieS.WangA.LuoC.et al (2025)
For patients who experience a paradoxical decrease in energy levels, it doesnt mean you should stop taking the B12 but instead decrease your dose by half (so take 2,500mcg every 7 days) or simply take 5,000mcg every 14 days instead
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