Topiramate is the generic name of a medication called Topamax. Topiramate is an anti-epileptic medication that has many additional off-label uses, including to promote weight loss. Although people have experienced weight loss as a result of this medication, the drug has serious additional side effects that warrant extreme caution about its use for weight loss. Always talk to your doctor before starting any new medicine.
Official Uses
Topiramate is approved by the U.S. Food and Drug Administration to treat seizure disorders, such as epilepsy, and for migraine prevention. Topiramate is used to treat partial-onset and primary generalized tonic-clonic seizures in adults and children over age 10. It can also be used along with other medications to treat these types of seizures and Lennox-Gastaut syndrome in adults and children over age 2.
Off-Label Uses
Topiramate also has several off-label uses, including weight loss. It is also used as a mood stabilizer for patients with bipolar illness. It is not considered a strong enough mood stabilizer for use alone, so it is usually used in combination with stronger medications such as lithium or valproic acid.
Side Effects
Topiramate has many major side effects, including weight loss. Other side effects include dizziness, loss of coordination, kidney stones and excess ammonia in the blood. Another common side effect is slower cognitive processing, including forgetting the words you were trying to find. This deficit in cognitive processing can be severe enough to affect job or academic performance.
Effectiveness for Weight Loss
According to the American Diabetes Association, approximately 75 percent of patients lose weight as a result of taking topiramate. It is thought that the main mechanisms responsible for weight loss are reduced sense of taste, aversion to food and loss of hunger sensations, and a reduction in glucose levels. However, these effects last only while you are taking the medication, so any weight lost would be regained when you stop the medication. Many patients in clinical trials for weight loss stopped taking topiramate because of the side effects.
Contraindications
Use caution before taking topiramate if you have a history of depression or mood disorders, glaucoma, metabolic acidosis, lung problems or chronic diarrhea. You should also consult with a doctor about taking topiramate if you are on a high-fat, low-carbohydrate diet called a ketogenic diet. Women who are pregnant or may become pregnant should also use caution, as it is unknown how topiramate affects a developing fetus.
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