Topiramate for Weight Loss

Introduction

Topiramate Notably, topiramate may help people lose weight by lowering their triglyceride and cholesterol levels, calorie consumption, and fat gain. A physician or other healthcare provider may prescribe Topamax (topiramate) off-label to help patients lose weight. Although the medication is not authorized for this usage, some people have reported that it helps them lose weight.

Topiramate is an anticonvulsant medication used to treat alcohol addiction, generalized or focal seizures, epilepsy, and migraine prevention. It has also been shown to result in weight loss when administered to prevent migraines and control seizures. Some doctors prescribe this to patients who need to lose weight but have seizures or migraines, even though the Food and Drug Administration (FDA) has not yet approved it as a medication for weight loss.

However, for obese or overweight individuals with type 2 diabetes, high blood pressure, or high cholesterol who also need to exercise, the FDA has approved Qsymia. This weight-loss drug combines Phentermine and Topiramate.

The following conditions are treated with topiramate, a prescription anticonvulsant drug also marketed under the brand name Topamax:

• Seizures with a partial onset
• Grand mal seizures, or primary generalized tonic-clonic seizures
• Alcohol addiction or alcohol use disorder
• Preventing migraines
• Controlling weight
• To treat seizures in people with Lennox-Gas taut syndrome, topiramate may also be used in combination with other medications.

Oral tablets and oral sprinkle capsules are the two types of Topamax. Topamax comes in a generic form and is a member of the anticonvulsant medication class.

Topamax has been licensed by the Food and Drug Administration (FDA) to help prevent migraines and treat some types of epilepsy. For weight loss, doctors may occasionally prescribe Topamax off-label. (Off-label drug use is the practice of prescribing an FDA-approved medication for a reason other than the one for which it is licensed.)

To learn more about Topamax for weight loss, continue reading. See this comprehensive article on Topamax for information on its authorized applications and more.

What is Topamax?

Topamax is a member of the class of anti-epileptic drugs. The FDA has approved it to prevent migraines and treat seizure disorders. Weight loss is a common side effect reported by people using Topamax for various conditions. As a result, several studies have evaluated Topamax’s potential as a weight loss tool.

The FDA has only approved Topamax for weight loss when used in conjunction with phentermine. The brand name Qsymia (phentermine/topiramate) is used to sell this combination. As mentioned before, using Topamax by itself to reduce weight is considered an off-label use.

Sixty-three percent of medical professionals polled in 2012 said they had prescribed Topamax to help people lose weight.

What you should know about using Topamax (topiramate) to lose weight

The surge in weight-loss drugs has yielded several encouraging remedies for the persistent obesity problem in the US. One of these is topiramate, an anti-epileptic medication that is frequently marketed under the Topamax brand.

Healthcare professionals are increasingly recommending topiramate and similar medications to assist patients to reach and maintain a healthy weight, even though the FDA has not approved the prescription for weight loss. This article will look at topiramate’s effectiveness as a medication for weight loss, how it works, and things to think about before taking it.

Using Topamax off-label to lose weight

Topamax may be prescribed off-label for weight loss even though it is not approved for this use.

People who are overweight or obese may be advised to lose weight by their doctor to reduce their risk of developing certain health issues. These include several forms of cancer and heart problems.

The precise mechanism of action of Topamax for weight loss is uncertain. However, it’s believed to have the effect of suppressing your appetite, which results in you eating less. It might also lessen food cravings and help you feel fuller sooner. According to other research, Topamax may help reduce leptin levels, which are a hormone that instructs your body to accumulate fat.

Additionally, Topamax has been demonstrated to enhance insulin sensitivity in patients on antipsychotic drugs such as olanzapine (Zyprexa). Topamax aids in preventing or reducing weight gain, which is frequently observed with this family of drugs.

The kind and amount of food ingested, body type, hormones, lifestyle, and social environment elements, including availability of nutrient-dense food metabolism

Before using Topamax

There are some crucial things to consider before your doctor recommends Topamax for weight loss. If you have specific medical disorders or other variables that affect your health, the medicine might not be a safe choice for you. Before taking Topamax, see your physician if any of the following health conditions apply to you:

• Issues with the eyes, including glaucoma, are caused by working in hot conditions.
• Renal disease, including chronic kidney disease.
• Respiratory disorders such as chronic obstructive pulmonary disease after a ketogenic diet.
• Sadness, persistent diarrhea, or other mental health issues.
• Suicidal ideas or actions in the past.
• Osteoporosis or weakened bones caused by another illness.
• Liver disease, such as cirrhosis, that will require surgery.
• Drinking alcohol when pregnant and nursing.
• An adverse reaction to any of the components in Topamax.
• Learn everything there is to know about Topamax interactions.

The price of Topamax

Topamax’s price is influenced by multiple factors. These may include the medication you take, your location, your insurance plan, and the pharmacy you visit.

A generic form of the name-brand drug Topamax is called topiramate. Generic medications are typically less expensive than brand-name ones. You can get advice from your doctor about whether using the generic off-label to lose weight is safe. If so, they can also assist you decide if you should take a generic or name-brand medication.

What is the purpose of topiramate?

Topiramate is within the category of anticonvulsant (seizure) drugs.

Topiramate is a prescription medicine used either alone or in combination with other medications to treat specific epileptic seizure types. Partial-onset seizures, primary generalized tonic-clonic seizures, and seizures linked to Lennox-Gas taut Syndrome are all treated with topiramate.

Additionally, it is utilized to avoid migraine migraines. Once a migraine has begun, topiramate won’t stop it.

To assess a person’s weight for health, medical experts employ certain instruments and measurements. The body mass index (BMI), which calculates a person’s weight about their height, is one such tool. In general, a person with a BMI between 25 and 29.9 is overweight. Study up on body weight.

Some drugs may aid in the loss of extra weight. In addition to a healthy, balanced diet and lifestyle modifications like increasing physical exercise, medical practitioners may advise these drugs.

How to use Topamax to lose weight

Using Topamax to lose weight can be harmful to your health.

According to research, using Topamax may be harmful to your health, particularly if you have a history of eating disorders or are at risk of developing one. Seven teenagers who used topiramate and developed disordered eating were evaluated in one case study. Three individuals had eating disorders before taking Topamax, three had eating disorders after starting the drug, and one had been in recovery from an eating disorder. Food restriction was the main symptom shared by all of the teenagers, and some also participated in purging and bingeing.

Adhering to a trendy diet, such as the ketogenic diet, might be regarded as disordered eating, although it does not always indicate that an individual has an eating disorder. Furthermore, using Topamax for weight loss while on the ketogenic diet may be particularly risky because of the drastic fluctuations in body weight and the possibility of metabolic acidosis, which is caused by an accumulation of acid in the body.

One consequence of metabolic acidosis is:

• Exhaustion and Hyperventilation
• Cardiac arrhythmias that are stupor
• Kidney stones
• Softening of bones
• Osteoporosis

Additionally, it might cause appetite loss, which can worsen conditions like osteoporosis by causing further weight loss from a lower-calorie diet.

Dosage of Topamax for weight reduction

There is no set “normal dose” or maximum dosage of Topamax for weight loss because it is not authorized for this purpose. Nonetheless, several studies have shown that Topamax works well for weight loss when taken at the following daily dosages:

60 mg, 96 mg, 150 mg, 192 mg, 256 mg, and 384 mg

Topamax does not have an approved dosage for weight loss. When used alone, Topamax has been shown to have effective dosages ranging from 64 mg to 400 mg daily. Although they are linked to more adverse effects, doses at the higher end of this range may provide greater weight reduction.

The beginning dosage for Qsymia is 3.75 mg/23 mg (phentermine/topiramate) taken orally once daily for 14 days. After that, the dosage is increased to 7.5 mg/46 mg (phentermine/topiramate) orally once a day. Depending on how you are reacting to the drug, your doctor may decide to increase your dosage after 12 weeks (3 months).

Each person will have a different ideal dosage of Topamax for weight loss. Together with your doctor, you can determine a dosage that works well and is safe for you.

Which dosage of topiramate is ideal for weight loss?

The topiramate brand that is most frequently given, Topamax, comes in oral tablet form in dosages of 25, 50, 100, and 200 milligrams (mg). Since Topamax is not authorized as a weight reduction aid, there is no recommended standard dosage.

It is possible to start with standard dosages of 25–50 mg daily and work your way up to 100 mg or more. However, each person will react differently to the drug, so your doctor will decide on the right dosage for you based on your medical history and other variables.

Notify your doctor if you start experiencing adverse effects if you are prescribed Topamax. In this case, your doctor might lower your dosage or recommend a different course of treatment.

How to purchase Topamax to lose weight

Consult your physician if you’re interested in using Topamax to lose weight. They can prescribe Topamax and assist in determining whether it would be an appropriate option for you.

Getting Topamax through a trustworthy telehealth provider, like Ro Body, is an additional option. Your health will be assessed by a qualified telehealth specialist. They will provide you with an electronic prescription if they think Topamax would be a good fit for you. After that, you can use the service to order the medication. To help you control your weight, the services also include coaching and other forms of support. You should let your doctor know if you receive a prescription for Topamax from Ro Body. They must be aware of every prescription you take.

Get discounts to help you save money on your prescription drugs and find out how much Topamax costs.

When using Topamax, how long will it take to lose weight?

Weight loss was observed in studies as early as one month (four weeks) following the initiation of Topamax. Results from Qsymia can be seen during the first eight weeks of medication, however it may take longer.

According to studies, you usually lose more weight the longer you take Topamax. As previously indicated, higher dosages appear to produce greater weight reduction but may also result in more adverse effects. However, remember that gradual weight loss is healthier and more long-lasting.

After roughly six months, other weight loss drugs might no longer be as effective. But this doesn’t seem to be the case with Topamax. Even after a year of treatment, weight loss appears to persist, particularly for people with a body mass index of 30 or higher.

Even after a year of treatment, weight loss appears to persist, particularly for people with a body mass index (BMI) of 30 or higher.

If using Topamax doesn’t result in weight loss, what should you do?

There are a few things to think about if you’re taking Topamax and not losing weight:

• Give it some time. You might not have waited long enough for Topamax to start working. Before concluding that it isn’t working for you, it is advised to wait at least four weeks.
• Make sure to account for lifestyle changes. Maintaining a nutritious diet and engaging in regular exercise will help Topamax function better. Consult your medical team for advice on how to make long-lasting adjustments.
• Modify your dosage (with permission from your doctor). See whether you can take a greater dosage of Topamax by speaking with your doctor.
• Try a different drug. Discuss alternative weight-loss drugs with your doctor if Topamax doesn’t work for you. Finding the solution that best suits your individual health needs may need some trial and error.

Is topiramate safe?

The U.S. Food and Drug Administration (FDA) authorized topiramate in 1996 for the treatment of epilepsy and specific forms of seizures.

For the majority of adults and children over 12, topiramate is regarded as safe and effective. Negative side effects are possible for some individuals.

Numbness, tingling (paresthesia), slowed reactions, anxiety, headache, drowsiness, weakness, shaking, eye movements, weight loss, digestive issues (constipation, nausea, stomach pain), changed taste, dry mouth, nosebleeds, and irregular menstruation are among the most frequent side effects of topiramate.

Dizziness and impaired coordination are side effects of topiramate. These negative effects can be exacerbated by alcohol and other central nervous system (CNS) depressants, such as sedatives and some painkillers.

Although they are uncommon, serious adverse effects could include:

• Problems with the skin (rash, blisters, peeling)
• Vision issues include double vision, impaired vision, loss of vision, eye pain, and redness.
• Convulsions
• Having chills, feeling cold, or having a low body temperature
• Cognitive difficulties (memory, speech, confusion, and difficulty focusing)
• Loss of consciousness, or coma
• Issues with coordination
• Symptoms associated with the heart, such as shortness of breath, chest pain, and a pounding or irregular pulse
• Modified mental state (inability to react to changes in mood or environment)
• Fatigue
• Digestive issues (vomiting, diarrhea, appetite loss)
• Kidney problems (abnormal urine, severe side or back discomfort)
• Urinating frequently and experiencing pain
• Infection symptoms (fever)
• Issues with bleeding or bruises
• Osteoporosis

Higher topiramate dosages are often linked to a higher chance of negative side effects. Consult a qualified healthcare professional for medical guidance if you start to experience topiramate side effects.

• What safety measures must be followed before using topiramate?

Tell your doctor about any health issues you may have, any drugs or supplements you are currently taking, and any past pharmaceutical side effects before beginning topiramate treatment. Birth control pills are among the drugs whose effectiveness may be diminished by topiramate.

For some people with pre-existing medical issues, topiramate may be dangerous.

Physicians may refrain from providing topiramate to patients who have:

• Suicidal ideas or actions in the past
• A history of kidney stones
• Acidosis due to metabolism
• Osteopenia, osteomalacia, and osteoporosis are examples of bone disorders.
• Glaucoma
• respiratory conditions such as COPD or asthma
• Mood disorders or depression
• Issues with growth
• Thyroid conditions
• Liver illness
• Kidney disorders

Because topiramate raises the danger of kidney stones, it’s critical to drink enough water when taking the drug. To lower your chance of kidney stones, drink lots of water and think about talking to your doctor about taking supplements like potassium citrate.

If you are on a ketogenic diet—a low-carb, high-fat diet used to treat seizures—let your doctor know because taking topiramate on a ketogenic diet can raise your chance of developing metabolic acidosis.

Women who are pregnant, trying to conceive, or nursing are not eligible to receive topiramate prescriptions.

How Topamax aids in weight loss

The exact mechanism of action of Topamax for weight loss, migraine prophylaxis, and other purposes is unknown. It is believed to have something to do with Topamax’s capacity to either block or strengthen specific electrical signals in the brain.

According to research to date, Topamax may help people lose weight in the following ways:

• Reduce your caloric intake, potentially by changing the molecular signals that occur after meals.
• Reduce the quantity of fat your body stores after meals.
• Reduce your blood’s triglyceride and cholesterol levels.
• Reduce blood sugar levels.

If you want to learn more about how Topamax works, speak with your pharmacist or doctor.

When is the ideal time to take Topamax to lose weight?

For other medical disorders, Topamax is usually given once or twice a day. Your doctor will decide on the appropriate dosage and frequency for you because there isn’t an approved dosage for weight reduction. You can take Topamax with or without food because it does not affect how well it works.

Qsymia should be taken in the morning once a day. Qsymia contains phentermine, a stimulant that may make it difficult for you to fall asleep. You should not take it in the evening because of this.

You can take Topamax with or without food because it does not affect how well it works. Qsymia should be taken in the morning once a day. Qsymia contains phentermine, a stimulant that may make it difficult for you to fall asleep. You should not take it in the evening because of this.

The effectiveness of Topamax

Even though Topamax isn’t authorized for weight loss, a 2023 assessment of earlier studies According to a reliable source, it works well for this purpose in adults.

According to one study, persons with obesity who took Topamax every day for 24 weeks saw an average weight loss of 4.8% to 6.3%. In a different trial, persons with type 2 diabetes and obesity who took Topamax every day for 24 weeks along with metformin saw an average weight loss of 4.5% to 6.5%.

It’s crucial to remember that in these studies, Topamax was used in conjunction with dietary and lifestyle modifications. Additionally, each person will experience different weight loss outcomes when using Topamax.

If you have any more concerns about the effectiveness of using Topamax off-label for weight loss, speak with your physician or pharmacist.

Did topiramate cause weight loss in studies?

Indeed, studies on adults and children have shown weight decrease. Generally speaking, between 6% and 17% of patients lost weight, and this tendency tended to increase with greater dosages.

Adults with seizure control: Patients aged 16 and older who were using topiramate (Topamax) at two dosages per day (50 mg or 400 mg) without the use of other seizure medications had their side effects evaluated. Two of the most often reported adverse effects were weight loss and anorexia.

Weight loss was recorded in 17% of patients receiving the higher 200 mg/day dose of topiramate and 6% of patients receiving the lower 50 mg/day dose.

Additionally, 4% and 14% of patients, respectively, had anorexia (lack of appetite), which can result in weight loss.

In a study of people taking topiramate (Topamax) as an adjuvant treatment for seizures, weight loss was observed in 9% of patients taking 200–400 mg daily and 3% of patients taking a placebo (an inert pill). These figures were 1% and 9% in children, respectively.

Prevention of migraines: Six percent of individuals taking 50 mg daily for migraine prevention lost weight, compared to nine percent of patients taking 100 mg daily. On the other hand, 1% of patients in the placebo group saw weight loss. Anorexia affected 9% to 15% of topiramate users, however, it also happened to 6% of placebo users.

Side effects of Topamax

Serious or mild side effects are possible with Topamax. Some of the more frequent adverse effects listed in Topamax clinical studies for FDA-approved purposes are listed below. When using Topamax to lose weight, comparable side effects are anticipated.

The following are a few of the most typical adverse effects of Topamax:
When using Topamax to lose weight, common adverse effects include delayed thinking and movement, altered taste perception, and unusual skin sensations (such as burning, tingling, or numbness).

Health hazards and side effects of topiramate

Using topiramate to lose weight can have several negative effects, including:

• Anxiety
• Feeling sleepy
• Hand or foot numbness
• Tremors or shaking
• Constipation, nausea, and stomach pain
• Excessive menstrual bleeding
• Absence of menstruation
• Pain in the bones
• Loss of weight

Serious adverse effects could consist of:

• Overheating
• Suicidal thoughts
• Liver illness and impaired liver function
• Cloudy or bloody urine
• Urinating in pain
• Typical bleeding or bruises
• Severe back or side discomfort
• A fever

Contact your physician right away if you encounter any unsettling topiramate side effects or an odd or allergic reaction. They might change your dosage or suggest that you stop taking it.

• Issues with focus and memory
• I’m anxious
• Changes in mood
• Mouth dryness
• Vision changes
• Feeling queasy or lightheaded
• Weariness
• Loss of appetite and weight
• Discomfort in the abdomen, changes in food flavor
• Dizziness, sleepiness, and diarrhea
• Anxiety
• Nausea and paresthesia, or a tingling sensation in your arms and legs
• Delayed responses

According to studies, taking more than 96 mg of Topamax daily is typically linked to increased adverse effects. To prevent unintended side effects from this drug, it is preferable to use the lowest effective dose. Speak with your healthcare provider if any side effects are bothering you. To control them, they might need to adjust your prescription.

These Topamax side effects could only last a few days to a few weeks. However, it’s crucial to speak with your doctor or pharmacist if they worsen, persist longer than this, or annoy you.

Although uncommon, Topamax may cause major side effects, such as:

• Speaking difficulties and memory issues
• Alterations in eyesight
• If you experience severe adverse effects while taking Topamax, contact your doctor immediately. Find out more about how to handle the negative effects of Topamax.

For weight loss, who shouldn’t use Topamax?

As with any drug, there are hazards involved with Topamax. The following conditions may be caused by or made worse by Topamax:

• Suicidal ideas or actions
• Osteoporosis (brittle or weak bones)
• Kidney or liver issues
• History of excessive blood acid, or metabolic acidosis
• Glaucoma

Additionally, Topamax may harm a developing fetus. If you’re pregnant, you and your medical team should decide whether Topamax is right for you by weighing the risks and benefits.

Before taking Topamax, it’s crucial to inform your doctor about your medical history and any other medications you’re taking. This aids them in ensuring that the treatment is safe for you.

Does topiramate have any substitutes?

Nowadays, a lot of prescription medications are used to control weight, including topiramate. Nonetheless, the FDA has approved topiramate principally for the treatment of epilepsy and seizures. Larger dosages are most effective for weight loss, but they also carry a larger risk of negative side effects. Consult your physician about the following if you’re searching for a topiramate substitute:

Semifluid: When taken in conjunction with a balanced diet and consistent exercise, this diabetes medication helps patients lose weight. Semifluid reduces hunger, slows stomach emptying, and regulates blood sugar levels to prolong feelings of fullness. Semifluid is an ingredient in the name-brand drug Segovia, which is specially authorized for the treatment of obesity in people without type 2 diabetes.

Similar to semifluid, tripeptide is a GLP-1 receptor agonist that is used to treat obesity and type 2 diabetes. It slows stomach emptying, lowers hunger, and controls blood sugar levels. Tripeptide-containing Ze bound is a brand name that is particularly authorized to treat obesity in individuals who do not have type 2 diabetes.

Liraglutide: The FDA has approved liraglutide, a GLP-1 receptor agonist, to treat obesity in adults and children aged 12 and up. It functions by slowing stomach emptying and lowering blood sugar and hunger.

Naltrexone/Bupropion: Bupropion makes it easier to limit calorie intake by decreasing appetite and increasing feelings of fullness. As an opioid receptor antagonist, naltrexone helps lessen cravings and the rewarding effects of eating, especially for foods heavy in calories and sugar.

The FDA has authorized Contrive as a weight-management tool for people who are obese or overweight with a weight-related medical condition.

Metformin: Some patients have been reported to lose weight when taking this prescription medication for diabetes. It functions by enhancing insulin sensitivity and controlling blood sugar levels. The amount of sugar in the blood is reduced by increased insulin use.

For a more specialized topiramate therapy option, discuss Qsymia (topiramate/phentermine) with your doctor.

What makes Qsymia and Topamax different from one another?

A well-known prescription drug called Topamax is authorized to treat epilepsy, some forms of seizures, and migraine prevention. Topiramate, the active ingredient in Topamax, is mixed with the appetite suppressant phentermine in Qsymia. Qsymia is an FDA-approved weight-loss drug, in contrast to Topamax.

Adults with a body mass index (BMI) of 30 kg/m2 or higher who are obese or overweight (BMI of 27 kg/m2 or higher) and who additionally suffer from weight-related illnesses such as type 2 diabetes, high blood pressure, high cholesterol, or cardiovascular disease are eligible to utilize Qsymia.

Qsymia is taken as an oral capsule with prolonged release. Usually taken in the morning, it is taken once daily. Depending on how well the patient handles the drug, doctors will first prescribe a low dosage of Qsymia before progressively raising it. It is recommended in conjunction with lifestyle modifications like eating fewer calories and exercising more.

It is crucial to remember that Qsymia has been demonstrated to have negative side effects. If consumed during pregnancy, it may raise the risk of congenital defects. Not every patient who wants to control their weight should use Qsymia. Discuss the advantages and possible hazards of Qsymia with your healthcare physician for additional details.

Conclusion

Some patients who use the anti-epileptic drug Topamax (topiramate) experience weight loss. The use of Topamax alone for weight loss is regarded as off-label. However, it is paired with phentermine in Qsymia, a weight-loss drug that has FDA approval.

According to research, Topamax appears to help patients lose weight and is generally well tolerated. The weight-loss benefit of Topamax appears to last after six months, in contrast to certain other drugs. Although higher dosages of Topamax increase the likelihood of adverse effects, they often lead to greater weight loss.

Not everyone who wants to lose weight should use Topamax as a medication. The safety and suitability of this drug for you can be determined with the assistance of your healthcare team.

When used in conjunction with lifestyle modifications like regular exercise and a nutritious diet, topiramate can be a useful weight-loss aid. It is frequently prescribed off-label for weight loss even though the FDA has not approved it as such. Research indicates that it can result in substantial, long-lasting weight loss over time.

It’s crucial to balance the possible benefits and drawbacks because side symptoms including tingling, exhaustion, and in rare instances, more serious problems like kidney stones or mood swings, might happen. Topiramate may ultimately be a useful weight-loss aid, but to guarantee safety and efficacy, it should only be taken under a doctor’s supervision.

FAQs

Reference

• Does topiramate cause weight loss? (n.d.). Drugs.com. https://www.drugs.com/medical-answers/topiramate-weight-loss-3555918/
• Mba, A. B. P. (2024, October 17). Topamax for weight loss. https://www.medicalnewstoday.com/articles/drugs-topamax-for-weight-loss#cost
• Dangers of using Topamax for weight loss. (n.d.). https://withinhealth.com/learn/articles/topiramate-topamax-weight-loss-risks
• Can topiramate help me lose weight?: Southwest Family Physicians: Family Practice. (n.d.). https://www.swfamilyphysicians.com/blog/can-topiramate-help-me-lose-weight