Medications and various other procedures for weight loss are among the most sought after treatments globally. Increasingly high rates of obesity and lifestyle diseases are attributed to this surge in demand for treatment. Individuals undergoing treatment with certain psychotropic drugs for specific ailments are known to end up with weight loss due to the properties of these drugs. This could be a boon for patients with the condition who are also over weight or obese, while it could be a problem for patients who are underweight already. A common question posed to specialists treating seizures and epilepsy is – does topiramate cause weight loss? Subsections in this article offer answers to this question, along with important contextual information that will help patients and caregivers handle undesirable effects of the medication effectively.

What is topiramate used for?

Belonging to the category of anticonvulsant drugs, Topiramate is used as treatment for epilepsy and as a prophylactic for migraine. In use since approval almost three decades ago for managing epilepsy and seizures, it later received approved as a prophylactic drug for individuals with migraine. The discovery of the medication has a history – it was actually discovered by chance, during the process of research on a drug to treat diabetes. Interestingly, as the drug was known to contribute to weight loss, due to its effects, it later received approval as a combination drug for weight management. This drug was made available in the markets as an extended release formulation.

Topiramate is distinct from other medications belonging to antiepileptic category mainly by the chemical, which comprised sulfamate, and a very high percentage of oxygen – that was determined to be almost 40%.

How effective is Topiramate for Weight-loss?

There have been documented reports of the drug contributing to weight loss in a measurable manner. The combination formulation of Phentermine and Topiramate, is recommended for patient diagnosed as obese or overweight. The drug is typically recommended for patients looking for weight loss due to underlying conditions, such as type 2 diabetes, high levels of cholesterol, and hypertension. It is also known to be effective in patients who require exercise for managing weight.  The dosage of the drug at which weight loss was recorded as an outcome was recorded as anywhere between 50 mg to 400 mg daily. The studies showed that patients who were put on a low dose of Topiramate ended up losing around six percent of weight, while patients on higher dosages were found to have lost as much as seventeen percent of weight.

The study also looked at the effect of the drug on children, in terms of weight loss. While the statistics did indicate that children also experienced significant weight loss, it is a prudent option to use this drug after other simple options have not succeeded. This is because of the possible loss of appetite that may be experienced by around one tenth of the child patients, and this could have an effect on overall nutrient requirements.

Suitability of the drug

The drug, while delivering measurable results to patients grappling with weight issues, is considered suitable for certain sections of patients. In other words, this is not regarded as a suitable drug for certain categories of patients. Individuals diagnosed with glaucoma are not to take the medication, Similarly, individuals with osteoporosis, and metabolic ketoacidosis are also not to be put on Topiramate. The drug is known to amplify certain behaviors and thoughts, and this makes it necessary to ensure constant monitoring of the patient and understanding the medical history of the patient. For instance, it is known to increase depression and suicidal tendencies in patients with the conditions.

Patients with certain ailments also need evaluation by a specialist and explicit approval before taking the drug. These conditions include kidney ailments, and impaired liver function or diseases. Patients with existing lung disease or breathing complications are also to take consent from the treating specialist. Overweight pregnant women are also not to take the drug as this could result in an extremely adverse condition, that could endanger the life of the pregnant woman as well as the baby. In certain rare instances, Topiramate is prescribed for pregnant women, and this is typically only when the drug is specifically recommended for its anticonvulsant and anti-epileptic properties and outcomes.

Commonly reported side effects of topiramate

All drugs come with the possibility of undesirable effects and Topiramate is no exception. These effects are attributed either to the mechanism of action of the medications, or the properties of the compounds and other active ingredients in the medication. Effects are typically classified into mild or moderate effects, and serious or adverse effects. These effects do not afflict all users of the medication, with only a section of users experiencing certain effects. Some users are known to be fully free from all side effects of drugs whatsoever.

The actual nature of effects or the intensity of effects experienced by patients depends on various factors. For instance, this could be related to the age of the patient, the gender of the patient, the overall health condition, the severity of the condition being treated, the dosage and schedule of the drug, presence of other ailments, and the use of medications that may contraindicate with the drug. The mild effects are known to resolve naturally without the need for any medical intervention. This may take a few days or a couple of weeks. For certain patients, effects disappear after the initial stage of taking the medication, while for some, the effects disappear when the medication is stopped. The serious or adverse effects require medical intervention almost always, and in certain circumstances, it may be necessary to seek urgent or emergency treatment. This may be required to prevent an effect from turning dangerous and life endangering in nature.

Commonly reported effects include memory related issues, overall fatigue not attributed to any other condition. Patients have reported insomnia, while others have contrastingly reported feeling excessively drowsy. Other effects that may be experienced include a distinct tingling sensation in the hands and limbs. Effects include low grade or high grade fever, apart from difficulties in concentrating. Bouts of diarrhea, and sudden loss of appetite are other reported effects of the drug.

What you cannot take with topiramate

Relative contraindications are other possibilities that may be experienced with all drugs. This is due to the conflicting mechanisms of action of two or more drugs that may be taken together for either treating the same condition or for treating two different conditions. The effects of this relative contraindication are generally of three types. The first type is wherein the efficacy or potency of either of the two drugs may be more than the expected or desired efficacy or outcomes. The second is the opposite of the first effect, wherein the outcomes or efficacy of either of the two drugs are reduced considerably. The third effect is an aggravation of the side effects of either or both the drugs, when compared to the effects that may have occurred if the medications were taken along.

Specialists typically resort to different remedial or preventive methods to overcome this possibility of relative contraindications. The first option is to understand the medical history of the patient and check out all the medications being taken by the patient as a course, or even as an ad hoc measure (medications that are prescribed to be taken “when required”). After understanding the categories of medications and the possibilities of interactions, specialists recommend, temporary discontinuation of one of the two drugs. This is determined by evaluating the importance of each drug and its role in terms of seriousness of ailment. In the event that both the drugs are to be taken on a lifelong basis, one of the two medications are permanently discontinued. These medications are then replaced by other alternatives that are not known to have any relative contraindication.

The second method to handle drug interactions of topiramate is alter the dosage of the drugs and the intake schedule so as to give as much a gap as possible between the intake time of both drugs. The dosage is modified so as to minimize or mitigate the possible interactions. This option is used when both the drugs are equally important and cannot be discontinued. Patients may also require to be monitored periodically, to check for any indications of effects. Telltale symptoms and results of diagnosis or laboratory tests are often used to monitor such interactions.

Categories of drugs that interact with topiramate include birth control pills. It is therefore necessary families to look at other contraceptive or barrier options as a replacement for birth control pills. Other medications that may interact with Topiramate include drugs that are prescribed for treating seizures, such as pioglitazone and hydrochlorothiazide. As Topiramate is known to increase feelings of drowsiness, and overall fatigue, this may aggravate the effects of medications that have similar effects. For instance, individuals on pain relievers that belong to the category of opioids are likely to experience drug interactions. This could also have an effect on individuals who consume alcohol.

Leave a Reply