A combination of phentermine and topiramate extended release treatment could help overweight or obese adults to lose at least 5 percent of their weight.
The extended-release phentermine plus topiramate is an FDA approved drug for treating obesity.
Past studies have been shown that 7.5 mg phentermine and 46 mg topiramate daily dosage over one year led to a minimum of 5 percent weight loss.
A study found that when the phentermine and topiramate dosage increased, the weight loss was 10 percent or greater in obese and overweight patients.
Topiramate is an approved anti-convulsant drug which is used for treating seizures and preventing migraine.
Phentermine is an appetite suppressant medication used for treating obesity in conjunction with diet and exercise.
A 12-week trial by Guerdjikova et al., 2018, suggests that the combination of phentermine and topiramate extended-release (brand name Qsymia) together with a low-calorie diet and higher physical activity would effectively lower weight and body mass index (BMI).
They found that the combined phentermine–topiramate medication reduces binge-eating symptoms in patients with binge-eating disorder.
Dr Caroline Kramer and colleagues found that a 28-week daily dosage of 96 to 200 milligrams topiramate on its own resulted in 10 percent or greater weight loss.
The review investigated 10 trials on 3,300 overweight or obese patients who took topiramate over four months and lost 11.8 pounds (5.4 kg) compared with those who took “dummy” pills known as placebo.
Dr Kramer, the study’s lead author, said:
“Topiramate is not an approved drug for the treatment of obesity.
Data from individual clinical trials might not be sufficient to support physicians’ decision to prescribe it for this use, and robust evidence of its safety is lacking.”
The weight loss benefits appear to increase the higher the dosage and the longer the treatment.
However, higher doses of phentermine medication alone or with topiramate would make patients experience serious side-effects such as depression, anxiety and insomnia.
Dr Kramer said:
“Topiramate has a substantial effect on weight loss, at least comparable to the weight loss that other anti-obesity drugs induce.
We have so few pharmacological options for the treatment of obesity that I believe topiramate can be a useful tool together with diet and exercise.”
However, she emphasised that patients need to be aware of the possible side-effects.
The adverse effects include paraesthesia, a burning sensation of the skin, cognitive impairment like slower thinking, low concentration, memory loss, and movement disorders.