Topiramate, sold under the brand name Topamax, controls epileptic seizures. Epileptics may take Topamax alone or in combination with other anti-convulsant drugs. Doctors also sometimes prescribe Topamax for patients with migraine headaches. Since Topamax suppresses the appetite, doctors may prescribe low doses in people who have trouble with weight gain from other psychiatric drugs. Patients who experience weight loss while taking Topamax may also see a corresponding drop in cholesterol. Topiramate is available in dosages ranging from 15 to 200 mg.
Topamax and Weight Loss
An experimental drug called Qnexa combines topiramate with phentermine. In human trials, people who took Qnexa lost more weight than those who received counseling. Study participants who took a variation of the drug that contained 46 mg of topiramate and 7.5 mg of phentermine lost an average of 18 pounds during the 56-week study, while those on a form of Qnexa that contained 92 mg of topiramate and 15 mg of phentermine lost an average of 22 lbs. Those on the drug also lowered their blood pressure, blood sugar, blood cholesterol and triglyceride levels, although whether this was due to an effect of the drug or the weight loss alone was not established.
Topamax and Cholesterol
The scientific evidence on whether taking Topomax will lower your cholesterol is inconclusive. A 2007 study of 70 patients aged 6 months to 22 years who took topiramate for the control of seizures found little difference between the cholesterol levels of those patients and other patients of the same age who did not take topiramate. Those for whom topiramate was the sole medication did see a slight decrease in their HDL, triglyceride and total cholesterol levels, but researchers did not feel the difference was significant. A 2011 study of 72 adult schizophrenia patients who had gained weight from the psychiatric drug olanzapine found that adding topiramate to their drug regimen resulted in weight loss, as well as lowered blood sugar, blood pressure and cholesterol levels. Again, whether the improved cholesterol numbers were due to the drug or to the weight loss was not established.
Topamax Side Effects
Like many anti-seizure medications, Topamax can make you feel drowsy. Some people experience dizziness, and you shouldn't drive while taking the drug until you're sure of its effect on you. Topamax can damage the liver, so you'll need regular blood tests to check your liver function. Topamax can also increase the likelihood of developing kidney stones. Other drugs may increase or decrease the effect of Topamax, so consult your doctor if you take other medications.
Precautions
You should never take anti-convulsant medications such as Topamax without your doctor's supervision. If you're taking these drugs and wish to discontinue them, you can't quit them suddenly. You'll need to taper off the drug over a period of weeks, under your doctor's supervision. Topamax can increase the sedative effect of alcohol or sleeping pills, so avoid drinking or taking sedatives while on the drug without your doctor's permission.
References
- HealthFinder.gov; Experimental Weight-Loss Drug Seems to Work: Study; Steven Reinberg; April 2011
- Stanford School of Medicine: Psychiatric Drugs - Topiramate
- "European Journal of Neurology"; Topiramate - Effects on Serum Lipids and Lipoproteins Levels in Children; E. Franzonio, et. al., December 2007
- "Schizophrenia Research"; Topiramate for Prevention of Olazapine Associated Weight Gain and Metabolic Dysfunction in Schizophrenia; P. K. Arula, et. al.; May 2010
