Disclaimer: None of the information in this article constitutes medical advice, and is just the opinion of the writer(s). We recommend that patients follow their doctor’s guidance in regard to weight loss medication or supplementation.
Topamax is a seizure medication that’s used off-label by some individuals for weight loss. While the drug is not FDA-approved for the treatment of obesity, users claim the drug can cause significant weight loss.
But is Topamax actually proven in research studies to cause weight loss? Does the drug have any dangerous side effects? Is the generic version really 97% cheaper? And what dose is used for weight loss?
In this article we’ll answer all of these questions and more, as we review research studies on Topamax for weight loss to give our take on whether or not it's likely to be effective.
We’ll also discuss side effects, document the dose proven to cause weight loss, and document how much cheaper the generic version really is.
Key takeaways:
- Clinically shown to cause weight loss
- Not FDA-approved for weight loss
- Can cause severe ocular side effects
Is Topamax Proven to Cause Weight Loss?
Topamax is the brand-name version of a drug called topiramate. These terms refer to the same active drug ingredient and we’ll use them interchangeably throughout this article.
This medication has been studied for its effects on body weight changes.
A medical review published in the Obesity Reviews journal analyzed data from 10 clinical trials on Topamax that track body weight changes.
The researchers found that, on average, patients lost 11.77 pounds while taking Topamax compared to taking placebo. The average trial length was between 16 weeks and 28 weeks.
Another medical review on the weight loss effects of Topamax concluded the following:
“[Topamax] is able to induce weight loss, especially in high baseline BMI patients.”
The medical reviews above predominantly analyzed results from clinical trials on Topamax in adults. But the weight loss effects have also been shown in adolescents.
A 2015 clinical trial examined the body weight changes from Topamax use along with lifestyle changes in severely obese adolescents. The average age of trial participants was slightly over 15 years old.
The average reduction in BMI after 6 months of Topamax treatment was 4.9%.
Based on the available research, we consider Topamax likely to be effective for weight loss in adults and adolescents.
However, we want to be very clear that this drug is not FDA-approved as a weight loss drug, which means there may be risks involved in using it for that reason. We would strongly urge patients to speak with their doctor prior to taking this drug off-label for weight loss.
Is Topamax Dangerous?
Topamax does cause side effects in some patients.
A medical review on the drug published in the Pharmacological Research journal described the most common side effects as dizziness, fatigue, visual disturbances, ataxia, mental slowing and impaired concentration.
At the time of publishing this article, there is no FDA black box warning for Topamax, which is required by the regulatory organization when a drug may have life-threatening side effects.
A 2022 medical review reported that Topamax can also have eye-related side effects, some of which are severe.
According to the above-linked review, the medication can cause choroidal effusion syndrome, angle-closure glaucoma, myopic shift, retinal problems, uveitis, visual field defects, myokymia, and neuro-ophthalmology complications.
This suggests that patients with existing eye-related issues should discuss their pre-existing eye conditions with their doctor prior to using Topamax.
Given the lack of a black box warning, Topamax seems to be somewhat less risky than some prescription medications we’ve reviewed on Illuminate Health, but it can still cause serious side effects.
Nearly 10,000 people per month search “Topamax ruined my life” in Google at the time of publishing this article, according to SEMRush data.
What Dosage of Topamax is Used for Weight Loss?
The daily dosing range described in the first medical review on Topamax that we cited was 96 milligrams (mg) to 200 mg.
The dose used in the adolescent trial was 75 mg per day. Typically adolescents take lower doses of prescription medication than adults.
These doses are actually lower than the standard Topamax dose for seizure patients, according to a StatPearls review that describes the dosing range as 200 mg to 400 mg daily.
Is the Generic Version Better?
The generic version of Topamax is called topiramate, as we discussed in the first section of this article.
Generic drugs are as effective and as safe as brand-name drugs on average, according to an extensive 2019 medical review that analyzed data from over 2 million patients.
This makes sense, given that both generic and branded drugs contain the same active drug ingredient.
For patients considering Topamax, we would recommend speaking with your doctor about generic topiramate instead, because it should be equally effective and may be significantly cheaper (especially for those without health insurance).
GoodRx reports the current retail price of Topamax (25 mg) to be over $200 at the time of publishing this article.
Cost Plus Drugs currently sells generic topiramate (25 mg) for $5.44 (link).
That’s a potential cost savings of 97% from using the generic version of the drug.
Our Healthy Body Weight Picks
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Dietary fiber was shown in a medical review published in The Journal of Nutrition to help reduce body weight when combined with moderate caloric restriction (750 calories per day below baseline).
MBG Organic Fiber Potency+ is our top fiber pick because it's certified organic, provides 7 g of fiber per serving and costs under $1.85 per serving at the time of updating this article.
Both of the products mentioned in this section are free of ingredients that we consider to be unhealthy.
These statements have not been evaluated by the FDA. These products are not intended to diagnose, treat, cure, or prevent any disease.
