Topiramate for weight loss: Can this antiepileptic drug help you shed kilos?
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Ozempic, used for treating diabetes, is quite popular among people who want to lose weight. But it is not the only weight loss drug that may show positive results. Your doctor may also recommend another medication called topiramate for weight loss. The US Food and Drug Administration (FDA) has approved it for treating epilepsy, a brain condition that leads to seizures. But it is yet to get a green signal by the FDA for using it to lose weight. Still, doctors may prescribe it to some people, especially those who are obese. Before taking this medication for weight loss, know how it may help and if there are any side effects.
What is topiramate?
Topiramate, mostly sold under the brand name Topamax, is a prescription medication primarily used to treat symptoms of epilepsy. It can be prescribed for epilepsy treatment for children aged 2 years and older, according to research published in StatPearls in 2024. Called an antiepileptic medicine, topiramate helps to reduce bursts of electrical activity in the brain, as per the UK’s National Health Service. It also works by restoring the normal balance of nerve activity. It can also be taken to prevent migraine, a severe headache that leads to throbbing pain on one side of your head.
“In recent years, it has gained attention for its off-label use in managing weight,” says surgeon Dr Nikhil Gupta, who specialises in bariatric, general, laparoscopic, and minimal access surgery. This means the FDA has not approved topiramate by itself for the purpose of losing weight.
Topiramate for weight loss: Here’s how it works
There is evidence to prove that having topiramate for weight loss works. During a 2013 study, published in the Journal Of Research In Medical Sciences, researchers found that topiramate induced weight loss and improved glycemic control in diabetics who were obese. The weight loss drug was also found effective in non-diabetics. A 2011 analysis, published in Obesity Reviews, showed that people treated with topiramate lost an average of 5.34 kg.
“It has been found that taking Topiramate for weight loss is effective due to its different effects on the brain and metabolism,” says Dr Gupta. Here are some reasons why the doctor may prescribe topiramate for weight loss:
- Appetite suppression: It influences certain neurotransmitters in the brain, including gamma-aminobutyric acid and glutamate. “These changes may reduce appetite, leading to lower calorie intake,” says the expert. A 2023 study, published in the journal Life, showed that topiramate may contribute to weight loss by reducing calorie intake, and decreasing fat gain.
- Increased satiety: Doctors may prescribe Topiramate for weight loss as it enhances the feeling of fullness. “This can help you to eat smaller portions and feel satisfied for a longer time,” says the expert.
- Reduced impulsive eating: By stabilising mood and controlling impulsive behaviours, topiramate may reduce episodes of binge eating. When it comes to off-label applications, it is also used in the treatment of binge eating disorder, as per research published in StatPearls in 2024.
How to take topiramate for weight loss?
The first step to keep in mind before having topiramate for weight loss, is to consult a doctor.
- Dosage: “The typical starting dose for weight management is low, often around 25 mg daily,” says the expert. It is gradually increased based on your response and tolerance to the medication. Whether it is an oral tablet or an oral sprinkle capsule, it should be swallowed whole.
- Frequency: You may be told to take topiramate for weight loss once or twice a day.
“You may notice reduced appetite within the first few days to weeks, and see measurable results within 8-12 weeks,” says the expert. But you also need to stick to a healthy lifestyle for weight management.
What are the side effects of taking topiramate for weight loss?
Before having topiramate for weight loss, know that it comes with potential side effects, which include:
- Numbness or tingling that is often felt in the hands and feet
- Nausea
- Drowsiness or a general feeling of tiredness
- Dizziness, especially while starting or increasing the dose of topiramate for weight loss
- Foods may taste bland or different.
- Difficulty concentrating or recalling information. Allergic reactions such as hives, rash, or swelling.
- Dry mouth.
“You should stay hydrated to reduce the risk of dry mouth, or take the medication with food if nausea occurs,” suggests Dr Gupta.
Who should avoid taking Topiramate for weight loss?
- Pregnancy: Taking Topiramate for weight loss during pregnancy should be avoided, as it may lead to birth defects.
- Medical conditions: Those with a history of kidney stones, should discuss risks with their doctor.
- Drug interactions: While taking topiramate for weight loss, make sure you are not on another medication. “It can interact with other medications, including birth control pills and antidepressants,” says the expert.
If you are planning to try topiramate for weight loss make sure to do it only under medical supervision. By suppressing appetite, and enhancing satiety, it can support in achieving your weight management goals. However, don’t just rely on it to drop pounds. Combine this medication with a healthy lifestyle to lose weight and keep it off.
Can you take topiramate alone for weight loss?
While topiramate can be effective as a standalone treatment for weight loss, it is more commonly prescribed as part of a comprehensive weight management plan. This includes a balanced, calorie-controlled diet, and regular exercise tailored to the individual's fitness level. In some cases, topiramate is combined with phentermine in a fixed-dose combination for enhanced weight loss.
How many mg of topiramate is needed for weight loss?
The effective dosage varies from person to person. The starting dose is usually 25 mg per day. It gradually increases to 50-100 mg per day, depending on the response and tolerance.
What is the best time to take topiramate for weight loss?
This medication is available in two oral preparations. Immediate-release is often taken twice daily, in the morning and evening. Extended-release is typically taken once daily, either in the morning or evening, as directed by the doctor.
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