Topiramate (Topamax) for Treatment of Obesity

[Sparda29]

For the practitioners out there, how many of you have you seen patients being prescribed Topamax, exclusively for weight loss, even if they do not have any mental disorder, or epileptic history.

We were going over seizures in school, when the professor noted that Topamax would be a great treatment option for an obese patient with epilepsy. But would it be a good treatment option for someone who is just obese without any other conditions?

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[Farmercyst]

For the practitioners out there, how many of you have you seen patients being prescribed Topamax, exclusively for weight loss, even if they do not have any mental disorder, or epileptic history.

We were going over seizures in school, when the professor noted that Topamax would be a great treatment option for an obese patient with epilepsy. But would it be a good treatment option for someone who is just obese without any other conditions?

Diet and exercise would be the best treatment for most of them.
The ones that it wouldn't help would probably be best helped with some form of hormone therapy (thyroid or other) in addition to......diet and exercise.

 

[awval999]

The ones that it wouldn't help would probably be best helped with some form of hormone therapy (thyroid or other) in addition to......diet and exercise.

Weight reduction[U.S. Boxed Warning]:Thyroid supplements are ineffective and potentially toxic when used for the treatment of obesity or for weight reduction, especially in euthyroid patients. High doses may produce serious or even life-threatening toxic effects particularly when used with some anorectic drugs (eg, sympathomimetic amines).

 

[rx2010]

Weight reduction[U.S. Boxed Warning]:Thyroid supplements are ineffective and potentially toxic when used for the treatment of obesity or for weight reduction, especially in euthyroid patients. High doses may produce serious or even life-threatening toxic effects particularly when used with some anorectic drugs (eg, sympathomimetic amines).

Agreed, thyroid products should NEVER be used for weight loss.

 

[Moxxie]

It's already being studied as a combo product with phentermine - the brand name will be Qnexa.

It's in Phase III trials right now:
http://www.vivus.com/pipeline/qnexa-obesity

http://www.medicalnewstoday.com/articles/135287.php

The researchers claim that this combo doesn't seem to have a lot of reported adverse events, but I find that hard to believe. The weight loss in these trials is pretty astounding, too!

 

[Quiksilver]

For the practitioners out there, how many of you have you seen patients being prescribed Topamax, exclusively for weight loss, even if they do not have any mental disorder, or epileptic history.

We were going over seizures in school, when the professor noted that Topamax would be a great treatment option for an obese patient with epilepsy. But would it be a good treatment option for someone who is just obese without any other conditions?

well that or just like every other human being go out and cut out fast food and hit the treadmill

 

[Sparda29]

well that or just like every other human being go out and cut out fast food and hit the treadmill

Once I've told patients about the potential side-effect of Alli, they all say no.

 

[Quiksilver]

Once I've told patients about the potential side-effect of Alli, they all say no.

Canadians used to eat that **** up like gold.

ironically they all ****ted it out later. HA!

 

[Farmercyst]

Weight reduction[U.S. Boxed Warning]:Thyroid supplements are ineffective and potentially toxic when used for the treatment of obesity or for weight reduction, especially in euthyroid patients. High doses may produce serious or even life-threatening toxic effects particularly when used with some anorectic drugs (eg, sympathomimetic amines).

Sorry, it wasn't meant to indicate they'd be solely used for weightloss, but rather to restore a hypothyroid patient to a euthyroid status, thereby making weightloss, by diet and exercise, more feasible. I should have more carefully chosen my words.

 

[smileyangel11]

For the practitioners out there, how many of you have you seen patients being prescribed Topamax, exclusively for weight loss, even if they do not have any mental disorder, or epileptic history.

We were going over seizures in school, when the professor noted that Topamax would be a great treatment option for an obese patient with epilepsy. But would it be a good treatment option for someone who is just obese without any other conditions?

(1) One of the wonderful ADR of topamax is weight loss. I see it pretty universal in people regardless whether it is for sz or migraine. Avg weight drop from I see is ~ 5-10 lb.

(2) I do not think it will be a good choice as an anti-obesity drug because the ADRs are hard to tolerate for many people. Not many people would want to feel dumber to look thinner. The cousin drug, Zonisamide looks more promising as anti-obesity drug. JAMA published a trial in 2003 to evaluate efficacy in zonisamide for eight loss in obese patient (n = 60). The results were pretty impressive. So perhaps we see more of it in the future.

 

[eeyore spice]

Once I've told patients about the potential side-effect of Alli, they all say no.

I think it could be used kind of like disulfiram. Take it as an incentive to stick to a fat-free diet.

 

[Sparda29]

I think it could be used kind of like disulfiram. Take it as an incentive to stick to a fat-free diet.

It's a pretty crappy ADR though... literally. IMO, the best drug for weight loss would be a selective B-3 agonist, or a drug that causes severe appetite loss and nausea (when food is ingested), thus forcing the body to expend it's fat stores.