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The European Medicines Agency and FDA both acknowledge the theoretical risk in prescribing guidance but stop short of absolute contraindication

Most callers need help with: Managing side effects, such as feeling very anxious and delirious Navigating overdose situations Suicide attempts Doctors and nurses also call the Utah Poison Control Center for help to treat kratom withdrawaljust like they would for oxycodone or heroin

[2] Tirzepatide dual GIP/GLP-1 agonist pharmacology, PubMed

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For users that experience these side effects, your provider may suggest spacing out dose escalations even further (for example, increasing your dose every 6-8 weeks instead of every 4 weeks)