Why does topamax cause you to lose weight

Open studies for maintenance treatment in bipolar disorder and in the acute treatment of mania have so far been encouraging as reviewed in the Background. However, four large unpublished placebo-controlled monotherapy trials failed to confirm the efficacy of topiramate in the treatment of acute mania cited in [ 35 ] , indicating a poor antimanic effect, at least in monotherapy.

Our work was not designed to examine any mood-stabilizing properties of topiramate, as we did not use regular mood charts, the period of 12 months is too short to evaluate long-term benefits on the pattern of episodes, and there was no comparison group.

In addition, many of our patients were already talking a combination of mood stabilizers without complete treatment effect, having failed to achieve a long-term stability on a variety of treatments that had been tried over the years. In view of that, we did not expect any clear improvements in the mood or course of illness of this patient population. All we can conclude so far is that topiramate does not appear to be superior to other mood stabilizers in the long-term treatment of patients with treatment resistant affective disorders.

One of our patients had a manic relapse after we changed his carbamazepine with topiramate he was also receiving regular lithium prophylaxis. These two patients had refused to take other mood-stabilizing drugs for fear of weight gain and only agreed to take topiramate as monotherapy, having heard that it will not cause weight gain. Both of them suffered relapses of mania, which necessitated the addition of atypical antipsychotics and admission to hospital.

Although these three observations are anecdotal, they strengthen the impression that topiramate monotherapy does not have antimanic effect. Whether topiramate has any effect on the depressive side of bipolar illness is not yet know. Topiramate appears a very useful drug for weight reduction in patients with bipolar disorders.

The mood stabilizing effect of topiramate is however questionable. The very different results obtained from the controlled monotherapy trials of topiramate in mania and the open add-on trials summarised in the Background indicate that topiramate should not be prescribed as monotherapy in bipolar disorders as it has no acute antimanic effect.

In our opinion the current place of topiramate in the treatment of affective disorders is as an add-on treatment for patients who experience clinically significant weight gain, which could either compromise their physical health, or influence them to stop taking established mood stabilizers.

Topiramate should not be used in monotherapy and unless new research shows otherwise, psychiatrists should assume that it has no mood-stabilizing properties. Topiramate is known to cause neurocognitive side effects. Psychiatrists should monitor their patients carefully for the emergence of such side effects. As with most other mood-stabilizers anticonvulsants and lithium , women who may become pregnant should be warned of the possible consequences of taking such drugs during pregnancy [ 37 ].

Patients should be advised to ensure adequate hydration, especially if they are predisposed to nephrolithiasis [ 37 ]. J Clin Psychiatry. Article PubMed Google Scholar. Nemeroff CB: Safety of available agents used to treat bipolar disorder: Focus on weight gain. Am J Psychiatry. Silverstone T, Romans S: Long term treatment of bipolar disorder.

Fava M: Weight gain and antidepressants. Jallon P, Picard F: Body weight gain and anticonvulsants: a comparative review. Drug Safety. PubMed Google Scholar. Google Scholar. Suppes T: Review of the use of topiramate for treatment of bipolar disorders. J Clin Psychopharmacol. Obes Res. Marcotte D: Use of topiramate, a new anti-epileptic as a mood stabilizer.

J Affect Disord. Biol Psychiatry. Guille C, Sachs G: Clinical outcome of adjunctive topiramate treatment in a sample of refractory bipolar patinets with comorbid conditions. Prog Neuropsychopharmacol Biol Psychiatry. Clin Ther. Bipolar Disord.

Prog Neuropsychopharmacol Biol Psychaitry. Ann ClinPsychiatry. CAS Google Scholar. Lykouras L, Hatzimanolis J: Adjunctive topiramate in the maintenance treatment of bipolar disorders: an open-label study. Curr Med Res Opin. Yatham LN: Newer Anticonvulsants in the treatment of bipolar disorder. Aagaard J, Vestergaard P: Predictors of outcome in prophylactic lithium treatment: a 2-year prospective study.

J Affect Disorders. Screening for common and distressing side effects of antipsychotic medications. J Psychiatr Pract. Download references. You can also search for this author in PubMed Google Scholar. Correspondence to George Kirov. Kirov has received a grant from the Janssen Research Foundation for the collection of families with psychiatric disorders in Bulgaria for genetic studies. The current work is completely independent of that study, we have not informed the company of our work with topiramate, and have not shown them the manuscript.

Tredget's post is funded by AstraZeneca. None of the financial support received by the authors has been in any way related with the work described in this paper. GK was the psychiatrist in charge for the patients reported in this study. He performed most of the analyses and wrote the draft of the paper. JT is a Research Nurse who was closely involved in the day-to-day monitoring and supervision of the patients, performed some of the assessments, and organised the running of the clinic, thus contributing significantly towards data acquisition.

He revised critically the paper and contributed towards the analysis and discussion. Reprints and Permissions. Kirov, G. Add-on topiramate reduces weight in overweight patients with affective disorders: a clinical case series. BMC Psychiatry 5, 19 Download citation. Received : 30 November Accepted : 07 April Published : 07 April Anyone you share the following link with will be able to read this content:.

Sorry, a shareable link is not currently available for this article. Provided by the Springer Nature SharedIt content-sharing initiative. Skip to main content. Search all BMC articles Search. Download PDF. Abstract Background The weight-gain caused by many psychotropic drugs is a major cause for poor compliance with such medications and could also increase cardio-vascular morbidity among psychiatric patients.

Methods Topiramate was prescribed as part of our routine clinical practice, as an add-on medication, or as a replacement of a mood stabilizer.

Results Topiramate was effective in reducing the weight in 10 out of the 12 patients. Conclusion The evidence of a strong weight-reducing potential of topiramate is indisputable and clinically significant. Background Psychiatric patients who receive long-term mood-stabilizing agents can gain excess body weight [ 1 — 3 ].

Patients Patients in our mood disorders clinic are seen in regular intervals for long-term maintenance of their illness some have attended for over 7 years now. Table 1 Characteristics of the patients and changes of their weight during the study. Both individual and mean weight changes are presented.

The dose of topiramate is the highest dose reached. According to the Centers for Disease Control and Prevention CDC , exercise not only helps control weight, but it reduces high blood pressure, reduces the risk of Type 2 diabetes, and can even reduce the symptoms of depression and anxiety. Some great exercises for weight loss include walking, biking, swimming, and weight training. Stress is linked to many health problems such as anxiety and depression.

Feeling stressed can lead to emotional eating, which can lead to weight gain over time. Finding ways to reduce stress may help you lose weight. You might try meditating, yoga, going for walks, or calling a friend or family member. You can also ask your doctor or a counselor for proven ways to reduce stress that will fit into your lifestyle.

According to the Sleep Foundation , a lack of sleep may increase the appetite and lead to metabolic problems. Getting enough sleep can help your body function properly and give you more energy to do things like exercise, which will help you lose weight.

Getting enough sleep can also reduce your stress levels, which will help you control any urges you might get to overeat. Singh says. The mindset is the most important thing. Medications cannot serve as a substitute for proper eating and exercising habits. Skip to main content Search for a topic or drug.

Topamax for weight loss: See safety and efficacy info. By SingleCare Team Mar. Top Reads in Drug Info. Can you mix Trintellix and alcohol? Does hydroxyzine for anxiety work? Do coffee and Zoloft mix? Treating heartburn during pregnancy Oct.

Another meta-analysis of 10 studies published in the journal Obesity Reviews found that obese patients lost an average of 12 pounds on Topamax, compared to those who took a placebo. Those who took the drug for 28 weeks or longer had more significant weight loss than those who took it for a smaller amount of time.

But again, the study conclusion mentions that side effects need to be considered. And a JAMA meta-analysis and review of several drugs that could cause weight loss found that Topamax led obese patients to lose at least 5 percent of their body weight after taking it for a year. And, again, there are those side effects, which every study seems to warn about. Another thing you should know: It would take some solid time to lose weight with this drug.

A lot of patients gain the weight back after they stop taking it. Potential side effects are the biggie here.