Topamax For Weight Loss? How and Why it May Work

Topamax For Weight Loss? How and Why it May Work & More

Will using Topamax finally help you shed those unwanted pounds?

Maybe, but before you use it there are some things you need to know. 

In this guide you will learn how Topamax works for weight loss, why it may be effective, the side effects it can cause, what dose you need for it to work and other weight loss medications to compare it to

Let's jump in: 


What is Topamax (Topiramate)?

Obesity, it seems, is turning out to be a much more complex disease than was once thought. 

We tend to think of weight gain as a simple equation and one which can be solved by manipulating the number of calories that we consume and the amount that we burn. 

The problem with this strategy is that it has an abysmal success rate around 1%. 

So, with 99% of people failing to lose weight and keep it off, many people have started to look to their doctor or to prescription medication to help with weight loss

But do these prescription medications (from your Doctor) actually help with weight loss?

The answer is yes, but not always (and not always as much as you'd like them to). 

And that's where Topamax steps in, the topic for today's conversation.  

Topamax, otherwise known as Topiramate, is a prescription medication which was actually originally designed to treat the condition epilepsy (1).

weight loss in patients taking topamax vs placebo

It was found, though, that people who took Topamax started to notice weight loss (2) in addition to reducing the number of seizures that they had. 

This has obviously sparked great interest among both patients and Doctors as a potential way to lose weight. 

Recently, Topamax has been added to the medication phentermine in a combination weight loss pill known as Qsymia

So, with these concepts in mind, let's talk about who should use Topamax, who should avoid it and how it actually works. 

How Topamax May Help with Weight Loss

Most prescription weight loss medications focus on 1 of 3 very important mechanisms to help with weight loss:

  • Regulation of appetite (3) - Some medications focus on reducing your appetite which causes you to eat less food. These medications do NOT work very well long-term and almost always result in weight gain after you stop taking them. 
  • Regulation of hormones (4) - Other medications focus on "balancing" fat storing hormones such as leptin, insulin or thyroid hormones. Medications that focus on hormone balance tend to work long-term because they are treating the "root" of the problem. 
  • Regulation of metabolism (5) - Lastly, some other prescription medications help your body by increasing the number of calories that you burn. Medications that focus on this aspect usually result in long-term weight loss as well. 

Each prescription medication works slightly different from other medications which are why some tend to work better than others. 

In general, the more areas that your weight loss medication "attacks" the better and long lasting your results will be. 

For this reason, you generally want to avoid medications which focus solely on appetite reduction as a means of weight loss. 


Because these medications almost always result in the weight being regained once your appetite returns to normal making them largely ineffective! 

So, how does Topamax work? 

#1. Increases Energy Expenditure (Metabolism) 

One of the main benefits to using Topamax is that it may help increase what is known as your resting energy expenditure (6).

This refers to the number of calories that your body burns on a daily basis and is closely correlated with your metabolism. 

One of the biggest reasons that you may regain weight after a diet is due to a damaged metabolism. 

It is well known that reducing caloric intake results in a compensatory drop in your resting energy expenditure. 

Put in simple terms:

As you reduce your calories your metabolism will drop to match the amount that you consume. 

This drop doesn't rebound for YEARS which means that once you start eating a normal amount of food you will now be in a caloric surplus and start to regain weight

Topamax may help to keep the number of calories that you burn "steady" by boosting your metabolism. 

Medications which boost your metabolism are probably the "best" medications for weight loss because you don't necessarily need to alter the number of calories that you consume for weight loss. 

#2. Regulates Appetite

There is evidence to suggest that Topamax also helps by regulating your appetite (7).

And I don't necessarily mean that it reduces your appetite, I mean that it "regulates" it. 

Regulating refers to matching your appetite to the number of calories that you consume. 

In some people, this value is mismatched resulting in the consumption of more calories than what your body actually needs. 


Your metabolism can become damaged as a result of dieting and other factors. 

thyroid metabolism reset poster for side bar

If your metabolism is set at 1,500 calories per day and you believe it's at 2,000 calories per day then you may have a mismatch between the amount that you think you need to consume and the amount that you are actually burning. 

In some instances, your brain may also send signals to your body to consume more food even though you don't need it. 

These scenarios are becoming more and more common with conditions such as leptin resistance. 

Topamax may help with weight loss (8) by regulating the appetite center of your brain or your hypothalamus. 

#3. Enhances Thermogenesis

Topamax has also been shown to increase fat oxidation in both brown fat tissue as well as skeletal muscle (9).

Brown fat helps to provide your body with heat and is a crucial part of metabolism maintenance. 

Burning more calories in your muscles (skeletal muscles) may also be a way to improve metabolism and caloric burn day in and day out. 

This mechanism is not well understood but it appears that, through these mechanisms, Topamax may help increase the amount of energy and heat that your body produces. 

Why am I not Losing Weight on Topamax?

Let's face it:

Not all weight loss therapies work for all people. 

Even if your brother or sister used Topamax for weight loss (and it worked) doesn't mean it will work for you. 

Each of us has a different genetic composition and a different reason for weight gain. 

You may have gained weight due to extreme stress, due to binging or overeating or simply due to hormone imbalances such as menopause. 

The treatment for each of these will be different and they can't all be solved by one medication. 

So one of the main reasons that Topamax may not be working for you is because you are targeting the wrong problem. 

Other factors include:

  • It's not targeted to your weight gain - See above. Other common causes of weight gain include: insulin resistance, leptin resistance, binge eating disorder, menopause, thyroid disease and so on. 
  • You are not using the right dose - This usually isn't a problem but it's worth considering. We will discuss dosing below. 
  • There are better medications available to you - Not everyone will do well on Topamax and that's ok. Listen to your body and don't take the medication just because you really want it to work. 
  • You aren't combining it with a healthy diet or with exercise - No matter which weight loss medication you use you should always combine it with a healthy diet and exercise. Using weight loss medications by themselves often does not work. 
  • You haven't been using it long enough (10) - Weight loss should NOT be extreme and occur over a period of a few weeks. Long lasting weight loss often takes months and months to achieve. Topamax may take 6-8 weeks to kick in then months after that for more weight loss. 
  • Side effects of the medication may be causing weight gain - Some weight loss medications can paradoxically cause weight gain instead of weight loss. Be sure that you are not GAINING weight while taking Topamax. 

Topamax Dosage

The goal with dosing is to achieve a balance between dose and results. 

With this in mind, you'll want to use the smallest dose possible that still results in weight loss. 

For most people, this will be somewhere between 50 to 200mg per day (11).

Using this strategy will help reduce the negative side effects of this medication (listed below). 

You might find more success in combining Topamax with other weight loss therapies, supplements and diets as a means to help keep your dose low. 

Side Effects

While Topamax may be effective for weight loss it doesn't come without cost. 

Because this medication was originally designed to treat seizures (epilepsy) it works primarily by acting on the brain. 

It does this by "slowing down" the brain which may result in symptoms such as fatigue, brain fog, slow thinking and overall sluggishness (12).

These symptoms may be tolerable for some people, but for others, such as those who need a sharp mind for work, it may not be acceptable. 

It's always important to weigh the potential benefits vs the risks of using any therapy, including weight loss medications. 

You can see a long list of potential side effects of Topamax below:

  • Fatigue
  • Drowsiness
  • Diarrhea
  • Nausea
  • Brain fog
  • Slow thinking or poor cognition
  • Memory problems
  • Dizziness
  • Flu-like symptoms

The good news is that many of these symptoms tend to be dose-related, meaning the higher your dose the more likely you are to experience them. 

If you begin to experience these symptoms you may find relief by reducing your dosage to compensate or by adding another weight loss medication to your regimen. 

This is not a complete list of side effects, so just realize you may experience some not on this list. 

If you experience anything which you feel is serious, while using Topamax, make sure you discuss those symptoms with your Doctor! 

Topamax + Wellbutrin (or Topamax + Phentermine)

If you've been on my blog before you know I've discussed how other medications, such as Wellbutrin, can help with weight loss. 

You might be thinking that it's a potentially good idea to combine these medications together to enhance your results. 

And you may be right in that logic. 

Qsymia is a medication which has already done just that. 

Qsymia is the combination of Phentermine and Topamax in one pill (13).

Each pill contains around 3.75mg of Phentermine and about 23mg of extended release Topiramate

This dose can be increased up to 15mg of Phentermine and 92mg of Topiramate. 

topamax can be combined with other weight loss medications

You can get by with smaller doses of Topamax if you combine medications together, so instead of using Topamax by itself at 200mg per day you can use it in combination with phentermine and use only half the dose. 

The same may also be potentially true for combining Wellbutrin with Topamax. 

But because these medications can both interfere with neurotransmitters, using them together should be done very cautiously. 

I'm personally of the belief that, even though they may work, there are better options available for weight loss. 

The problem with some of these other medications is that they can be more difficult to get when compared to Topamax or Wellbutrin. 

Because of this, it's important for you to know all available options. 

Other Weight Loss Medications

It's important to realize that Topamax isn't the only game in town. 

There are actually many other potentially useful weight loss medications that you can draw from if necessary. 

If you've tried Topamax and it hasn't worked for you, or you experience significant negative symptoms, or you are afraid to try it, then you might find success with other medications. 

I've included a list of weight loss medications below that may also be useful:

  • Saxenda/Victoza - These medications primarily help by regulating leptin and insulin. 
  • Phentermine - This medication is an appetite suppressant and also may help boost metabolism. 
  • Wellbutrin - Wellbutrin works in a variety of ways and may help people with certain conditions. 
  • LDN (low dose naltrexone) - LDN can help reduce inflammation and help with weight loss, especially in those with autoimmune diseases. 
  • Qsymia - (Discussed in this article)
  • T3 thyroid hormone - T3 is the active thyroid hormone and can help boost metabolism in those with thyroid disease. 
  • hCG - This hormone can be used by itself to help regulate sex hormones such as estrogen, progesterone and testosterone. 
  • Testosterone - Testosterone can be used by itself to help increase muscle mass which may help improve metabolism. 
  • Metformin - Metformin helps regulate insulin resistance and can be combined with other medications for weight loss. 
  • Contrave - Contrave is another combination medication which includes LDN and Wellbutrin. 


Topamax is a medication which can potentially help with weight loss. 

It seems to work by regulating appetite, improving metabolism and helping your body burn more calories

That being said, it's not for everyone. 

This medication carries with it some serious side effects that should not be ignored. 

Don't worry though, because if it doesn't work for you there are still many other options available to you!

Now I want to hear from you:

Have you used Topamax for weight loss?

Did it work for you? Why or why not?

Did you experience any negative side effects? If so, what helped alleviate them?

Leave your comments and questions below! 

References (Click to Expand)

topamax for weight loss

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About Dr. Westin Childs

Hey! I'm Westin Childs D.O. (former Osteopathic Physician). I don't practice medicine anymore and instead specialize in helping people like YOU who have thyroid problems, hormone imbalances, and weight loss resistance. I love to write and share what I've learned over the years. I also happen to formulate the best supplements on the market (well, at least in my opinion!) and I'm proud to say that over 70,000+ people have used them over the last 6 years. You can read more about my own personal health journey and why I am so passionate about what I do here.

P.S. Need more help? Check out my free thyroid downloads and resources.

55 thoughts on “Topamax For Weight Loss? How and Why it May Work & More”

  1. Would Topamax or any of the other 2 items that you posted on here help me with weight loss if I no longer have a Thyroid?

    • Hi Donna,

      There’s no reason why they wouldn’t work, but it’s always more difficult to lose weight after thyroidectomy so it may not work as well compared to those who still have a thyroid.

    • I took topomax for a couple years and lost 25 to thirty pounds went back to old medication bc of insurance I gained weight back, plus I felt like crap. I went back to topomax did not lose any weight . I don’t understand. I take it for seizures but the weight loss was a huge benefit and I feel so bad now after gaining 50 pounds. I am 52 years old I have not had menapause yer. I do have thyroid issues . I would really like help.

  2. Thanks for your article, Dr. Childs. I know you mention that the list of side effects is not a complete list, but I feel it’s important to mention increasing depression and suicidality as major side effects as well. I experienced this recently after trying topamax for bulimia again after unsuccessfully using it years ago. Within a couple of days, all I could think of was killing myself. I was slow physically yet had racing thoughts. I would sleep slightly better but be jolted out of sleep into the suicidal thinking. It took me a few more days to connect the dots but I realized what was going on in time to not follow through with a very detailed plan of how I would kill myself. After a bit of research, I found that I am just one of many who have had similar reactions. I’m passively suicidal at baseline due to being enslaved by the beast I call bulimia. I try everyday to live normally, only to end up bingeing and purging for up to 12 hours at a time and spending hundreds of dollars every few days on food. I was really hoping Topamax would be helpful but it’s just not worth the impact on mood/cognition etc for me.

  3. I took Topomax for treatment of migraine in the past. The first time I took it I was in my 30’s and already fairly thin. I started to drop weight right away, so the doc took me off. I tried it again in my early forties (by then I had started to gain some weight-obesity runs in my family) so the benefit out weighted the risk. I took it for 3 years with no problem. I did loose some weight but not excessive amounts and it was working to treat the headaches. My neurologist bumped up my dose and it started to impact my personality so I stopped. Now I am coming up in 50, going through menopause and gaining weight like crazy. I have tried to restart on the end several times but it doesn’t seem to have the same effect. Does stopping and restarting have a negative effect on the effectiveness of the drug? I think if I stick with a smaller dose it could continue to help with migraines and maybe help me shed a few pounds. Have you had an experience with this? Thank you Grace

  4. Hello,

    How to maintain the weight loss after getting off Topamax? (On a 50-75mg dose)

    I am taking it for migraines but also enjoyed the weight loss that came with, however, I do not want to take it forever… but also do not want to gain back the sluggish extra pounds I couldn’t lose with diet and exercise. Thank you!

  5. My husband was prescribed Topamax for migraines. He did lose weight and his appetite was drastically reduced. He had to discontinue Topamax due to the severe side effects. The side effects were worse than the migraines. The worst one was probably the brain fog, spotty vision, and severe irritability. However, for weight loss, he did lose 10 lbs I believe on 50 mg a day.

    • Hi Tamar,

      I agree. I am not a huge fan of Topamax for the reasons you stated, but in some cases, it may be ideal to lose 50 pounds and deal with the side effects for a short period of time (though, not in the case of your husband it seems).

  6. Hello Dr. Childs, I have been on Topamax for almost 6 months for mainly weight loss and it has helped me a lot. I started out at 280LBS now down to 215 that’s 65 LBS!!! I’m on 25mg morning and night and I’m getting ready to turn 57. Just pray I can keep it off!!!

      • Is there anything I can take that will work like topamax for weight loss? I dropped weight so well on it but it then caused acne, then frequent urination. It’s the only thing that helped me lose weight. I’ve been on phentermine but it stopped working.

        • Hi Alissa,

          There are other weight loss medications which can work but there aren’t many that work exactly like Topamax.

    • Hi,

      I was on Topamax for a couple of months. And I lost 10 kgs. I was taking 200 mg per day. I was taking it because I wanted to lose weight. But now even I consume the tablet it doesn’t suppress my appetite any longer. Earlier it did and that’s how I lost the weight. I had smaller meals. Now I crave for sweets cheese and what not. I have started having hunger pangs. I am going to gain all the weight and will turn obese again. Will you help, please.

    • I lost 50 pounds on toprimate and phentermine. I’ve been on both for two years and about four to six months ago I started gaining weight – again. I’ve gained 30 pounds back. I guess the pills stop working after awhile. Plus I’m sure weight gain is bound to happen after you stop the pills anyway.

      • Hi Brenda,

        Not exactly. You will regain the weight if the pills were the only thing you changed, though. If you changed your lifestyle while simultaneously taking them then the weight tends to stay off.

  7. Hi! So I was on Topamax before back in 2016 for nerve damage due to lung surgery (long study) anyways I lost some weight on it which was great because I had a few pounds to lose and my hormones have been all jacked up since 2013 since I have been on the NuvaRing continuously (skipping periods due to endometriosis and lung collapse). Anyways I came off Topamax for almost 9 months cause my hair was falling out a lot and we were trying to rule it out (turns out the was clonazepam) anyways I’m back on it again cause the nerve damage was getting to me again physically and mentally. I will be at 50mg twice a day in about a week. I’m also on Wellbutrin for depression. First timer on depression meds. Lucky me. Anyways I’m at 300mg a day on that. If Topamax helped me with weight loss before, Will it help me again this second time? I’m 31 going to be 32. And will the Wellbutrin help too? My doc says they both would help with weight. But was not sure if Topamax is as effective the second time. And if Wellbutrin will help or hinder results. Thank you, sir!

  8. Been on Topamax for over a year for weight loss because I am on antidepressants and medications for bipolar disorder and Fibromyalgia that cause weight gain. Taking 50mg 2x a day. Do you have a better recommendation for me Dr. Childs? (Latuda and Gabapentin, previously Zoloft)

    • Hi Melissa,

      I have a list of weight loss medications at the bottom of this article that I would recommend you check out to see if they potentially fit for your current situation.

    • I have been on topamax for about 9 months for nerve pain due to multiple back surgeries. I’ve lost 68 lbs so far which has been very positive. I haven’t had the severe negative side effects. My only issues have been feeling cold and having to make myself eat. Losing the weight has improved my overall health.

  9. I used Topomax for close to 9 years then I went off I was up to 200 mg a day. I was taking fur migraines and I did lose weight 30-45 lbs with diet/exercise as well. Then I wanted another baby so I went off for almost 4 years. I did gain 32 lbs from being pregnant and had another 15 or so to lose pre-baby. Now I have a lot of weight to lose this time and still get terrible migraines. My question is trying this and another weight loss give me side effects of withdrawal if I get to maintain weight as well, I have fibromyalgia and arthritis ( car accident ) so I am hoping this will help with losing weight and my back pain.

  10. I’ve used this medication and I did great but the weight came back. I’m taking armour thyroid as well for my thyroid problem. I can’t take phentermine because I take Xanax for other reasons. I will assume that it’s because my thyroid is not working right and I also need to watch my calorie intake as well as exercise. I was 138 now I’m 164… Ugh

    • Hi Lakeisha,

      It’s probably more related to metabolic damage and how you lost the weight (calorie restriction), but your thyroid, which controls your metabolism, is no doubt playing a role as well.

  11. My doctor just prescribed me Wellbutrin and topromax. Do you think I will have a huge increase in side effects? Would my weight loss increase with this combination?

  12. I find this very interesting. I have been on Topamax 400mgm twice a day for numbness in my feet and back pain after a lumbar fusion 4 years ago for at least 2 years and Wellbutrin 150mgm Er for at least a year. I have certainly lost a considerable amount of weight over the past year. Originally the doses of Topamax were started lower and the Wellbutrin was started at a lower dose and I have only been on that for about a year and a half. Interesting information though thank you.

  13. I take Topiramate for my Binge Eating Disorder. I’ve always taken 75mg in the AM and 50mg at HS. In the beginning I had the tingling in my hands and feet. But I was told it was only a side effect and would cause no long term issues. It didn’t last long, and it only returned if I missed a dose. A couple weeks ago I decided to increase my HS dose to 75mg because I felt like my appetite was getting increasing/feelings of binge eating increasing. I’ve noticed some changes in my vision (I don’t normally wear glasses), a little bit of dizziness when I lay down, and some headaches. Can I expect these side effects to dissipate on their own as my body adjusts to the new dosage?


    Dawn, Kansas Nurse

  14. Hi, I’m on Topiramate for 3 weeks now. In addition to obesity I have SPD (sensory processing disorder). I present like a binge eater but it’s really the SPD, we either don’t eat or eat all the time. Anyway the net result is the same as binge eating. For the first time in my life I’m not a slave to food. Everyday I wake up wondering if this is real and praying it will last. The pounds are coming off with zero will power involved. I can eat anything I want because I just don’t want. I’m posting this in the hopes another SPD’r might stumble across it.

  15. My GP started me on Topiramate to prevent abdominal migraines. I started on 25mg and a week later went up to 50mg. A couple of days after the higher dosage I started with extreme diarrhoea and fatigue. My GP thinks this is rare and dropped me back to 25mg. I don’t want the abdominal migraines either.

  16. Melissa did it work for you in that year??? I’m bipolar as well and having to start Latuda yet I’m terrified of weight gain…I asked a new Dr for Topomax. I hope it worked for you…not sure why you’re asking for another one??

  17. Hi Doctor,

    My doctor recently put me on Topamax to help me lose weight and I’m also on Wellbutrin for depression. I took 50mg once daily of Topamax for about one week and just today he doubled that dose to 100mg once daily. I haven’t lost any weight yet and the side effects I’ve noticed in my first week include bloating, frequent urination, metallic tasting and extreme dry mouth and the frequent urge to drink a lot of water. I can also tell my metabalism is working faster or else my blood pressure is up 🙂 (hoping it’s the former). I haven’t really noticed a change in my eating habits yet except maybe once or twice I have felt full sooner than normal. So my questions are as follows:

    Do you think I’m scaling up to quickly in my dosages?
    How do you know when you’ve reached the dose that’s right for you?
    Is once a day only making a difference opposed to taking twice daily?
    What’s the difference between taking it once in the morning compared to once at night?
    Should I notice a weight loss after one week or too soon to tell?
    Is mixing with Wellburtin a good or bad thing (I was confused by the article above)?
    What is the longest a person can stay on Topamax and remain healthy?

    Thanks! I know that’s a lot of questions.

    Sincerely, Ashlee P

  18. In 2016, already taking Wellbutrin, I was put on 50mg per day of Topomax. In 6 months, I lost 60 lbs!!!! Then I gained it back due to going off the medication and hormone problems, however, I am currently trying again!!!

  19. Dr. Child, I am curious and have a question for you. I am on Topomax and have been for upwards of 3 years at a dosage of 100mg twice a day for migraines. I did not lose any weight originally nor in the next two years from taking it. However, I purposefully started a weight loss product in November 2017 to lose weight and in a matter of 45 days lost 13lbs and kept it off for 6 months. Then, I started to lose weight at what I would say is a good pace. I don’t need to lose anymore weight at this point, however I continue to do so. I inquired about this to my Neurologist today and he told me that it is my Topomax and that the weight loss can occur at any time while taking it. I want to get your thoughts on this. I am 5’3″ and now weigh in at 98lbs. I started at 129 when the plateau “lifted” if you will, roughly 10 months ago.

    Thank you for your time and insight.

    • Hi Heather,

      I’ve never seen weight loss quite that delayed but I do certainly believe that it is possible. I see similar things happen with other medications and therapies.

  20. I went on Topomax, and at first, I lost weight. After a few years on it, I started to gain weight. I took it at night just like the doctor said and the dosage was 200 mg. I am now trying to go off of it, and hoping I don’t gain any more weight. I just felt the medicine did not help in losing weight long term. Dr. is this normal that it won’t work for losing weight long term?

  21. Hello,
    My name is Donna. I was just prescribed Topamax 50 mg for insomnia. I also take Wellbutrin 150SR nice a day. I do suffer from headaches and migraines, I feel that is this rx will help both my headaches and insomnia it would be great. But my major concern is the hair loss side effects. I have read countless horror stories of hair falling out in clumps. I am scared to even try because of this. Is it truly a common side effect…. does it effect most ppl that take it? Please help to ease my mind a little.


  22. Hi all –

    I’m a 52 yo F, attorney, went on Topamax for migraines four years ago. I was already taking Wellbutrin for depression.

    I was up to 150mg/day – 75mg am and pm – and the “dope-a-max” factor was off the charts I’d forget words, was totally space cadet – combined with my then undiagnosed ADHD-(Inattentive-type) it was not a good scene. High expectations demanded at work and of myself.

    But…after literally 35 years of struggling, I lost more than 35 lbs. I hit a number I hadn’t seen since high school. Dream come true, right? Best side effect I’d ever experienced…until I got fired. I knew the Topamax was causing the majority of my fogginess, so – in order to get and hold a new job – I (slowly) cut way down to 25 mg per day.

    Long story short: all the weight is back on, plus 5 lbs. Awful work schedule w/2 hour commute cut into my sleep and workout time. So I can’t nail down if it was “just” the Topamax or the perfect storm.

    Got another, wonderful new job. Started my workout routine back up – thought this would be the key. But realized that my eating habits were out of control – I mean, I was HUNGRY, craved sugar (refined, please, thank you), and even knowing the probable effects felt the compulsion to ingest everything in sight. Worse than before I ever took Topamax.

    Now, I’m so miserable (and puffy) that I’m now going to add back another 25mg at night and see where it takes me, maybe also add a few Hail Marys that this’ll kick the weight loss back into gear.

    Remember the scene in “Charlie and the Chocolate Factory” when Violet Beauregard chews the gum and blows up into a blueberry-like ball? That’s me, sans blue.

    Good luck to everyone seeking health answers. Thank you, Dr. Childs, for bringing us all together on this “group think.” 😀

    Molly in Minnesota

    • Molly in Minnesota,
      I think you are hilarious and we need to be friends.
      I completely relate to what you are saying about needing to be sharp at your job and not forget words. I work in healthcare and I take 100mg of topamax to help with preventative migraines. Being in a healthcare setting you would think co-workers/colleagues would empathize with your side effect struggles. When I say this, I’m going to reference a movie as well, when Kate Winslet on Titanic is trying to describe the propellers on the ship and someone else has to speak up and fill in that blank for her. That’s me. Daily.
      However, the side effects have just become more out numbered and out weighed so, I’m going to look for an alternative medication. I will say I have lost probably 25lbs since starting topamax. I hope this says off.

  23. Hello,
    I’ve been taking Wellbutrin for depression for about 6 years (450mg now). About 5 years ago, my endocrinologist prescribed topiramate for weight loss. At the same time, I also began taking thyroid medication (new diagnosis). My endocrinologist gradually raised my topiramate dose to 50mg twice a day, and after about two months I was losing weight rapidly. I lost 100 pounds in 8 months: I went from 280 to 180. I was beyond ecstatic, but wasn’t sure what caused the weight loss- the topiramate, the thyroid medication, or the fact that the positive reinforcement from the weight loss helped encourage healthier eating habits, and a more vigorous workout routine. At that point, my endocrinologist checked my thyroid levels, and decided to cut my thyroid meds by 60%. I slowly started to gain weight, and I couldn’t stop it. Over the next few years I went from doctor to doctor, trying to tweak my medication levels, and stop the weight gain. I started experiencing peripheral paraesthesia, and we thought it might be a side effect from the topiramate, so we reduced, then discontinued it completely about 6 months ago. The tingling stopped, but I’ve been gaining weight rapidly. I’ve now gained back half of my initial loss, (50 lb) and I’m extremely distressed. I’m considering trying the topiramate again, as it seems it might have been an important piece of the puzzle.The paraesthesia was bad, but it seems a small price to pay for better physical and mental health. Do you have any insight? Thanks!

  24. I’m Topamax now and it works about 80% for my migraines. I just got off Wellbutrin and Lexapro and have now gained 40lbs. I’m worried that dosages is now wrong. The weight loss was a good fit for me as I did follow a good diet and I did exercise all because of the migraines. I did have a kid which is why I was put on the Wellbutrin and the Lexapro, but I worry that is what messed the Topamax.

  25. I’m a 51 year old woman and have been taking Wellbutrin for over 20 years for depression. In the last three years I have gained 27 pounds even though my diet and exercise habits hasn’t changed. I was put on a low dose thyroid medicine but that did nothing for my weight. Then 9 months ago for chronic migraines I was put on 100 mg of Topamax and 2 months ago my dr increased it to 150 and still I have not lost any weight. Even when I eat less and exercise more. Am I just one of the unlucky few these medicines won’t work for?

  26. Hi

    I have suffered from migraines for 39 years, chronic daily headache for 20 years and cluster headaches for 10 years. I had literally tried every medication except for Topamax which I had been saying no to due to the terrible side effects I’d read about. The pain was so bad it was either Topamax or surgery to fit an occipital nerve stimulator at the base of my skull.

    I’m hypothyroid so despite being on Levothyroxine my weight was higher than I would like at around 140 pounds (I’m 5’ tall).

    The side effects on Topamax have been tough, blurred vision, change in glasses prescription, brain fog, slurred speech, issues with balance, Repeating myself both when speaking and when writing emails, difficulty finding words, pins and needles in hands and feet, all fizzy drinks taste like sea water.

    However, my migraines and headaches, after 4 months have gone. My symptoms are starting to subside (they were so bad I had to have 3 months off work) And I now feel human again. My weight has dropped from 145 pounds to 113 pounds and I have more energy than I had when I was in my 20s (I’m 49).

    I am doing 10 mins of interval training 3 times a week and am also now doing daily press-ups (I never thought I’d say that!) as well as trying to maintain a healthy diet

    My dosage is 125mg split in to 50 in the morning and 75 before I go to bed.

  27. Hi
    I have taken topomax for 3 years now, i started it with many other mess because of seizures. I do not like the side effects but I am used to the others form all the other mess so I got used to them. I lost about 40 lbs the first 4 months but that’s it. It stayed off but slowly came back for about a year. I have always been over weight I guess. Just wondered if anyone has ever started topomax a second time and had luck of losing weight again? My neurologist agreed that I could slowly come off it and take a break from it, and start taking it again in a few months to a year. Just wondered if anyone has taken it 2 and lost weight a second time again?

  28. Hello, I used topiramate for weight loss some years ago. It was suppressing my appetite quite good, but I never got to increase the dose more than 50mg, because it caused increased eye pressure. Than I stopped using it for several weeks and started again, but could’t increase the dose more than maybe 10 or 15mg. Eye pressure was increasing again at this low dose. So I stopped and never used it again.
    Besides one must take in consideration that topiramate can cause kidney stones and is theratogenic.

  29. Hi I’am 65 years old an was wondering if there’s any older or seniors on the Topamax, an to share your experience taking the medication I just started on the medication a week ago. Thank you.

  30. I am trying the starter of Qsymia – and incredibly fatigued – I know its a possible side effect but it’s pretty bad – was hoping for a bit of energy! I am thinking to try taking it every other day? or maybe not take it at all? I was slowly losing over the 8 days…about 3-4 oz a day, which was great – but I am not sure I can handle the exhaustion. Also wondering will it get better at the next dose or If I should just ask Dr for other options. I am also on Ozempic .5, did lose about 12 lbs on just this over about 8 weeks – not going to win any races here, which is ok but it seems to have stalled – dr felt adding the Q would be a good compliment versus upping ozempic to 1. I just dont know but really need to lose 20 more lbs. so frustrating. Hashimoto, insulin wackiness, etc.

    • Hi AR,

      These weight loss medications can have all sorts of side effects that may necessitate switching from one to another.


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