Topamax for Weight Loss

The first-line management interventions in the management of obesity therefore relies on change in diet and exercise training. However for some individuals these guidelines may still not do enough for their improvements. It has been found out that medication works well in losing weight and in maintaining the same weight, if a person is willing to stick to healthy lifestyle.

Until now, there are limited anti-obesity medications and the majorities of these are acknowledged by the US Food and Drug Administration. Yet again, there are also several medicines that are used in the off label practices. This means they might help in losing extra pounds of weight though currently none of these products has received the  FDA approval for this use. One of such drugs is Topamax also known as topiramate. But what is Topamax and how can it assist in achieving weight loss? 

What is Topamax?

Topamax is in the anti-epileptic medication class. It is actually FDA approved as an antiepileptic drug for seizure disorders, and as a preventive treatment for migraine. These conditions are treated with Topamax and one of its side effects is weight loss. Therefore, Topamax has been brought forward in various studies as a potential weight loss treatment.

In its generic form called Topamax, it is only licensed by FDA for the weight loss after being used jointly with phentermine. Currently, the above combination go by the brand name Qsymia (phentermine / topiramate). However, Topamax can also be used for weight loss alone but this is not the normal standard use of the drug.

Despite the fact that using Topamax for weight loss is not approved by FDA, this medication is still prescribed very often by doctors. A survey conducted in 2012 showed that 63 percent of healthcare professionals who were surveyed had prescribed Topamax for use in the weight loss.

Does Topamax help in the weight loss?

The manner in which Topamax facilitates weight loss is not well understood. However it is postulated that it reduces your appetite which leads to little food consumption. It may also help to make you feel fuller for longer time and reduce hunger pangs. Other reports indicate that Topamax tends to decrease leptin level, a hormone that signals your body to store fat.

It also affects insulin sensitivity which can be helpful for those who have to take antipsychotics, such as olanzapine or Zyprexa. Topamax is used to prevent or reduce weight gain associated with this type of drug.

How does Topamax actually work for weight loss?

It appears that Topamax also aids in weight loss. The research indicates that it is possible to have about 5%- 7% weight loss within the 24 week intervention when taking Topamax. Greater amount of weight loss was associated with longer duration of treatment and high dosage of Topamax.

The newest product, containing Topamax and phentermine, called Qsymia, appears to be an FDA approved weight loss medicine that is the most effective. However, to date, studies show that Topamax or Qsymia is not as potent as newer injectable anti-obesity drugs, like Wegovy (semaglutide) or Zepbound (tirzepatide). 

Which dosage of Topamax is best for the weight loss?

Specifically, Topamax has not got an authorised dosage for weight loss. In scientific research, initial effective dosages of Topamax when taken alone are between 64 milligrams and 400 milligrams a day. Larger doses within this range will cause more weight loss but they will also cause more side effects. 

Regarding Qsymia, it is prescribed at initial 3.75 mg/23 mg (phentermine/topiramate) oral tablet once a day for at least, two weeks. It is then increased to 7.5 mg/46 mg (phentermine/topiramate) taken orally in the morning. Your prescriber can decide to increase the dose after 12 weeks (3 months) depending on how you are reacting to drug.

The dosage that would effectively help in tackling weight loss properly will drastically differ in every individual. It is always possible to talk to your prescriber and try to come up with a dosage that will work for you and is safe at the same time.

How much time will it take to lose weight using Topamax?

In trials, patients who took Topamax for weight loss showed results within 1 month (4 weeks) of beginning the process. Qsymia typical results may take longer, within the initial 8 weeks of use.

It has also been found that the more the patient continues to use Topamax the more the weight loss is likely to be. As was pointed out above, the elevating of the dosage also leads to weight loss but with an increased risk of the side effects. So remember that losing a few pounds a week is not only safer but also better for the long run. 

Other weight loss medications may become ineffective after about 6 months. However it seems that this is not so where Topamax is concerned. Weight decrease appears to persist beyond 1 year of treatment, particularly within patients with a BMI of at least 30.

Here’s what you can do if you are not losing weight while taking Topamax:

If you’re taking Topamax and you’re not losing weight, there are several things to consider:

• Give it time: 

Perhaps, you have not waited long enough to see the effects of Topamax on your body. One should try at least 4 weeks before coming to the conclusion that it does not help any longer.

• Do not forget to introduce lifestyle alterations: 

Topamax may be made more effective for you if you schedule a regular exercise and take a healthy diet. Talk to your healthcare team if you need more ideas on how to make such changes more lasting.

• Alter your dose (if for example, your doctor has agreed on it): 

Ask your prescriber if increasing the dose of Topamax is possible for you.

• Try a different medication: 

If you do not achieve your desired goal using Topamax, consult your prescriber who may recommend other weight loss products. 

What’s the best time to take Topamax for the weight loss?

Topamax is usually used 1-2 times a day for the other disorders. Since there is no prescribed dose for weight loss, your prescriber will closely calculate the optimal dosage and frequency for you. Topamax does not really affect food or beverages and therefore can be taken with food or without.

All medical practitioners recommend that Qsymia should be taken once in a day and the best time should be in the morning. Qsymia is a combination of phentermine and topiramate, where phentermine is a stimulant making it hard for you to sleep. That is why you should not take it in the evening.

What are the side-effects of Topamax?

Possible side effects when taking Topamax for weight loss include tingling or burning feeling on the skin, altered taste sensation, memory problems and slow movements.

Other notable side effects include:

• Feeling nervous
• Mood changes
• Dry mouth
• Changes in vision
• Nausea
• Dizziness
• Fatigue

Other research also has indicated that taking Topamax above 96 mg per day increases the possibility of side effects. It is also important to go for the smallest dose of this medicine because the side effects can be terrible. 

If any side effects are annoying, it is recommended to consult your healthcare team. In order to control those conditions they may have to adjust your dosage or change the type of medicine you are taking.

Who should avoid using Topamax for weight loss?

As it is with any medication in the market, there are certain side effects which one can be bound to face while taking Topamax.  

Topamax can cause or worsen the following conditions:

• Ideas/intentions of self-harmed or killed
• Osteoporosis, often referred to as, weak or brittle bones
• Liver or kidney problems
• Complicated medical history including metabolic acidosis which is an excess of acid in blood
• Glaucoma

Topamax may also harm a fetus in a pregnant woman. This means that if you are pregnant, you and your medical team should balance the risk which Topamax poses to you and the benefit it brings before considering to use it. 

The Bottom Line

Topiramate is the generic name for Topamax; it is an epilepsy drug, which also has a side effect of making some people slender.  However, using Topamax on its own to help people lose weight is called off-label use.  Therefore, it synergises with phentermine in an FDA endorsed weight loss drug known as Qsymia.

Such trials show that Topamax make subjects lose weight and have no serious side effects. It has been found that Topamax actually works for weight loss after first six months unlike most other drugs out there, and the results are permanent.  This is mostly so because with every dosage level of Topamax there is a proportional weight loss, but every level brings more side effects.

It means that Topamax is not an ideal medication for everybody who wants to shed some pounds. You should consult your healthcare team in order to learn if this medication is suitable for you.