The Turkish journal of pediatrics. Khera R, Murad MH, Chandar AK, Dulai PS, Wang Z, Prokop LJ, Loomba R, Camilleri M, Singh S. JAMA. You can also ask your doctor or a counselor for proven ways to reduce stress that might fit into your lifestyle. Your doctor will do a complete physical exam and ask about your medical history. Animal models Weight loss and loss of appetite (anorexia) were two of the most commonly reported side effects. Feeling stressed out can lead to emotional eating, which can lead to weight gain over time. Topiramate (used by itself) is not specifically approved by the FDA for weight loss, but some doctors may prescribe it if you have seizures or migraine and need to lose weight, too. We comply with the HONcode standard for trustworthy health information. The United States Food and Drug Administration approved the combination of these two drugs in 2012 to treat obesity. Acidification of the urine increases phentermine excretion. In a study done by the Journal of Clinical Psychiatry, bipolar and schizophrenic patients who were given an average dose of 195 mg of topiramate per day lost about 22 pounds over time. Dr. Kuldeep Singh, a top weight loss surgeon in the Baltimore Metropolitan area and Director of The Maryland Bariatric Center at Mercy Medical Center, says that most people will experience moderate weight loss from Topamax. Obesity is a global issue, and almost every country faces this serious public health problem. 2023 Jan 9;13:1043595. doi: 10.3389/fendo.2022.1043595. FOIA There are countless diet pills and supplements on the market that claim to cause weight loss, such as Hydroxycut and glucomannan, but they shouldnt serve as a substitute for healthy lifestyle changes. Repurposing drugs to treat cardiovascular disease in the era of precision medicine. For example, selective serotonin reuptake inhibitors (SSRI) can cause serotonin syndrome when combined with phentermine/topiramate. Kramer CK, Leito CB, Pinto LC, et al. If used off-label for weight loss, the dose will likely begin low at 25mg to 50mg once daily and increase slowly over weeks until a benefit of weight loss is noted balancing this desirable side effect with those which are less desirable. TPM is able to induce weight loss, especially in high baseline BMI patients, not strictly depending on daily dosage and perhaps not influenced by gender. 2016;2016(9). Topamax can be taken with or without food and is generally taken at the same time each day. 1999 Jun:6(2):149-52 [PubMed PMID: 10461560], Dabrowska A, Telec W. [New guidelines of Basic and Advanced Cardiopulmonary Resuscitation and Emergency Cardiovascular Care (ECC) American Heart Association (AHA)]. Eating healthy is one of the safest and best ways to lose weight. The pathogenetic mechanism underlying TPM-induced weight loss is still unclear. This makes TPM a good choice, especially in obese patients suffering from seizures. J Manag Care Pharm. Tremblay A, Chaput JP, Brub-Parent S, Prud'homme D, Leblanc C, Almras N, Desprs JP. Off-label prescribing happens when a doctor writes someone a prescription for a medication thats approved by the FDA to treat a condition thats different from what their patient has. Aside from its FDA-approved indication, due to its mechanism of stimulating. The other rare side effect of Topamax thats worth mentioning is eye problems that can lead to vision changes and blindness, which is why its so important to call your doctor if your vision starts to change. Migraine prevention - In adults using doses of 50 mg/day for migraine prevention, 6% of patients experienced weight loss, while in the 100 mg/day group, 9% of patients reported weight loss. Topamaxs weight loss side effect has resulted in its off-label use to treat binge eating disorders in adults, and the dosing for this indication does not differ greatly in comparison to other approved indications, ranging from 25mg per day to a maximum of 400mg per day. What is the difference between phentermine and topiramate? Results: 2013 Apr 15:111(8):1131-8. doi: 10.1016/j.amjcard.2012.12.038. 2015 Jun-Jul:24(5):e132-6. The .gov means its official. 2011;12(5):e338-e347. Topamax (topiramate) tablets and Topamax (topiramate capsules) sprinkle capsules. eCollection 2021 Nov. Abdelsayed M, Kort EJ, Jovinge S, Mercola M. Nat Rev Cardiol. Cureus. Weight loss can occur during topiramate (TPM) treatment and it should be evaluated by clinicians, especially in children, whose growth could be compromised. So people may be more likely to return to what they weighed before they started taking Topamax, but this may take some time. It is unlikely the dose of topiramate for the indication of weight loss needs to exceed 200 mg per day, as clinical trials have not demonstrated additional benefit in percent body weight lost beyond this dose. The tablet is offered in 25-, 50-, 100-, and 200-milligram (mg) formulations. Anthropometric Parameters of Children with Congenital Zika Virus Exposure in the First Three Years of Life. eCollection 2023. Intravenous phentolamine has been suggested for severe hypertension. Topiramate on its own has been used to treat partial-onset or primary generalized tonic-clonic seizures, Lennox-Gastaut syndrome, and as a prophylactic treatment of migraine headaches. The https:// ensures that you are connecting to the . People vary in how much physical exercise they need to lose weight, so its a good idea to talk with your doctor about how often you should be exercising. Although behavioral modification is important for the treatment of obesity, it is difficult to achieve an ideal weight or sustain the process of long-term weight loss. Accessibility According to meta-regression analysis, treatment duration and dosage were associated with the efficacy of topiramate treatment. Mechanism of Action Although the precise mechanism of action of topiramate is unknown, there is sufficient evidence to explain the drug's anticonvulsant activity. Drugs.com. Processed foods, refined carbohydrates, sugar, and alcohol are all examples of foods that can cause weight gain. The active ingredient in Topamax, topiramate, is the main ingredient in the weight loss drug. Still, some precautions are in order. Drug safety. Although its precise mechanism of action is unknown . Review the full topiramate (Topamax) information here, and discuss this and any questions you have with your doctor or other health care provider. Therefore clinicians should counsel the patient regardingweight-loss expectations. Zhang J, Chen S, Chen J, Zhang H, Rao WW. Topiramate is linked with many other side effects, including nausea, stomach pain, and taste perversion, which may impact weight loss or anorexia. Some medications that help manage Type 2 diabetes with a side effect of weight loss make more sense to use in a diabetic patient, whereas topiramate might be best suited for someone that suffers from migraines and needs to lose a little weight. The starting dose is usually 25 mg once a day in the evening. Anorexia occurred in 9% to 10% of patients taking topiramate and 4% of those taking a placebo. Disclaimer. Case reports of liver injury attributed to topiramate have occurred largely in patients with seizure disorders receiving other anticonvulsants with known hepatotoxic potential. Hormones (Athens). Efficacy and safety of topiramate on weight loss: a meta-analysis of randomized controlled trials. [Level 5], Silberstein SD. Its an anticonvulsant medication thats used to treat conditions like epilepsy, migraine headaches, and alcohol use disorder. Outline the indications for initiating topiramate/phentermine therapy in a weight loss regimen. Some great exercises for weight loss include walking, biking, swimming, and weight training. 2013 Mar:47(3):340-9 [PubMed PMID: 23482732], Coulter AA, Rebello CJ, Greenway FL. The site is secure. In addition, the critical care physician consultation is necessary if the patient requires MICU level of care requiring intubation and mechanical ventilation. Monitor for weight reduction and changes in heart rate. Anekwe CV, Knight MG, Seetharaman S, Dutton WP, Chhabria SM, Stanford FC. Studies have shown that Topamax may also speed up metabolism, which means that the body would be digesting food quicker than normal. The starting dose of Topamax for weight loss is a low dose of. doi: 10.1097/IJG.0000000000000157. In adults 16 years and older in the high dose group (400 mg/day), 21% of patients stopped treatment due to difficulty with memory, fatigue, asthenia (weakness), insomnia (difficulty sleeping), somnolence (extreme drowsiness), and paresthesia (pins and needles or tingling feeling in extremities). Any history of a mood disorder may increase the risk of recurrence with the use of this drug. Therefore, it is important to monitor heart rate in all patients takingphentermine/topiramate. Epub 2010 Aug 16. So if youre not able to take Topamax because of an underlying health problem or because youre experiencing too many adverse effects, you might try asking your doctor about Qsymia or other ways to lose weight. Centrally Acting Agents for Obesity: Past, Present, and Future. Getting enough sleep can also reduce your stress levels, which will help you control any urges you might get to overeat. Topiramate (TPM) treatment has been shown to reduce adiposity in humans and rodents. CNS drugs. Finding ways to reduce stress may help you lose weight. An extended-release formulation of topiramate co-formulated with phentermine is available as a product called. Anti-Obesity Medication Use in Children and Adolescents with Prader-Willi Syndrome: Case Review and Literature Search. Mechanism of Action Although the precise mechanism of action of topiramate is unknown, there is sufficient evidence to explain the drug's anticonvulsant activity. In that case, skipped the missed dose and then resume your usual dosing schedule. In an observational study done by the National Library of Medicine, discontinuation of Topamax for at least six months showed a trend for returning to a baseline weight. Predictors of weight loss in adults with topiramate-treated epilepsy. Usually, you'll begin with a low dose, which your doctor will slowly raise until it reaches the optimum for your condition. Endokrynologia Polska. Therefore, the obesity control guidelines strongly recommend lifestyle interventions along with medical . The medication's initiation begins with the lowest dose of 3.75 mg/23 mg phentermine mg/topiramate mg ER. Topamax can reduce the efficacy of oral contraceptives, so consider using additional methods as backup. In some studies, people lost up to 17% of their body weight while taking Topamax. Patients treated with topiramate lost an average of 5.34 kg (95% confidence interval [95%CI]-6.12 to -4.56) of additional weight as compared with placebo. If Topamax is causing too many side effects for you, know that you have other options. TPM is able to induce weight loss, especially in high baseline BMI patients, not strictly depending on daily dosage and perhaps not influenced by gender. If you have any of these symptoms, you should seek medical advice as soon as possible. Any decision on weight loss medications should be made in conjunction with a healthcare professional with a good understanding of all of a patients needs and conditions. to help someone lose weight. When people go for weight loss medications, most of them do it because its easy to do, says Dr. Singh. Your doctor might have to adjust your dosage to compensate. The Ochsner journal. Store Topamax at room temperature, out of direct light, and away from heat and moisture in a closed container. Sympathetic overactivity from fenfluramine-phentermine overdose. Doctors don't prescribe topiramate specifically for weight loss, but the drug often causes it. Epub 2021 Oct 16. A wide variety of Topamax alternatives is available, depending on the condition for which you take it. Bilateral angle closure following use of a weight loss combination agent containing topiramate. Summarize interprofessional team strategies for improving care coordination and communication to properly use topiramate/phentermine combination therapy to improve patient outcomes as part of a weight-loss regimen. Monitoring for increased intraocular pressure will help prevent permanent vision loss if an event occurs. It shouldnt be taken at the same time as certain other medications because of the potential for drug interactions. [9], The most common adverse events reported in clinical trials are dry mouth, constipation, and paresthesia. Here are some of the most common side effects of Topamax aside from weight loss: Although its rare, Topamax can cause more serious side effects that may require medical attention like confusion, memory problems, trouble concentrating, and trouble speaking. We do know that the drug blocks sodium channels that deliver electrical impulses to nerve, muscle, brain, and other excitable cells. Medically reviewed by Leigh Ann Anderson, PharmD. The additional benefit of Topamax in comparison to other weight loss medications on the market is that there does not seem to be a plateau of weight loss at six months, so the weight loss may be an ongoing effect. Epub [PubMed PMID: 24704892], Daudon M, Frochot V, Bazin D, Jungers P. Drug-Induced Kidney Stones and Crystalline Nephropathy: Pathophysiology, Prevention and Treatment. Migraine prevention - In adolescents 12 to 17 years of age, weight loss occurred in 7% (50 mg/day dose) and 4% (100 mg/day) compared to 2% in the placebo group. Nominate your favorite pharmacy staff for a Best of the Best award! This medication may cause difficulty falling asleep or staying asleep if it is taken in the evening. [19], Hepatic impairment: It is important to consider the Child-Pugh score for individuals with hepatic impairment. 2013 new drug update: what do new approvals hold for the elderly? Any patient with a history of the cardiac or cerebrovascular disease should use caution. In children 6 to 15 years of age in the high dose group (400 mg/day), 14% of patients stopped treatment due to difficulty with concentration/attention, fever, flushing, and confusion. A doctor may choose to write someone a prescription for Topamax to help with their weight loss or to treat eating disorders like binging and purging that lead to weight gain. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. Increase dose to phentermine 7.5 mg/topiramate 46 mg once daily for 12 weeks then evaluate weight loss. Getting enough sleep can help your body function properly and give you more energy to do things like exercise, which will help you lose weight. According to meta-regression analysis, treatment duration and dosage were associated with the efficacy of topiramate treatment. However, TPM can make nutritionally vulnerable children or adu So people may be more likely to return to what they weighed before they started taking Topamax, but this may take some time. Phentermine on its own has been used for short-term treatment of obesity in combination with exercise and caloric restriction. Data of 6620 individuals were available for adverse events evaluation and those more frequently observed were paraesthesia, taste impairment and psychomotor disturbances. Clinicians should monitor patients for suicidal ideations and behaviors, depressed mood, and increased anxiety. Side Effects of Trileptal (Oxcarbazepine), Invega: Benefits, Side Effects, Dosage, and Interactions, What to Know About Elavil (Amitriptyline), Daily Tips for a Healthy Mind to Your Inbox, Topamax (topiramate) tablets and Topamax (topiramate capsules) sprinkle capsules, Use of topiramate in the spectrum of addictive and eating disorders: A systematic review comparing treatment schemes, efficacy, and safety features, Topiramate treatment of aggression in female borderline personality disorder patients: a double-blind, placebo-controlled study, Efficacy and safety of topiramate on weight loss: a meta-analysis of randomized controlled trials: Topiramate and weight loss, Topiramate for acute affective episodes in bipolar disorder in adults, Preventive treatment in migraine and the new US guidelines, Migraine prevention in adults and adolescents 12 and older, Partial-onset seizure treatment in adults and children two and older, Primary generalized tonic-clonic seizure treatment in adults and children two and older, Redness of the face, neck, arms, or upper chest, Aggression, anger, agitation, irritability, Lack of interest or pleasure in things you ordinarily enjoy, Dizziness, fainting, or lightheadedness upon standing up. Heres a list of medications Topamax shouldnt be taken with: In addition to these medications, Topamax shouldnt be taken with alcohol because this can cause sleepiness, increase the risk of getting kidney stones, and cause metabolic acidosis. An official website of the United States government. Epub [PubMed PMID: 25096956], Grewal DS, Goldstein DA, Khatana AK, Tanna AP. HHS Vulnerability Disclosure, Help 2012:(): [PubMed PMID: 31644252], Davidson MH, Tonstad S, Oparil S, Schwiers M, Day WW, Bowden CH. Some people may not notice a difference until theyve taken the drug for at least four months, while other people may start to lose weight in their first month of taking it. Cochrane Common Mental Disorders Group, ed. [10], Phentermine/topiramatemay cause an increased resting heart rateof up to 20 bpm. Clinical dieticians should prescribe individual diet plans for the patient and educate the patient that a change in diet is necessary for any intervention to work. ), exercise not only helps control weight, but it reduces high blood pressure, reduces the risk of getting Type 2 diabetes, and can even reduce the symptoms of depression and anxiety. Lets take a more in-depth look at how safe and effective Topamax is, and see how its related to weight loss. 2004;65(11):1515-1519. doi:10.4088/jcp.v65n1112, Kramer CK, Leito CB, Pinto LC, Canani LH, Azevedo MJ, Gross JL. How long does Topamax stay in your system? and transmitted securely. Topiramate is a medication that is used to treat seizures and prevent migraines. An extended-release formulation of topiramate co-formulated with phentermine is available as a product called Qsymia, which is indicated for chronic weight management. All listed dosages are according to the drug manufacturer. 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