Topamax for Weight Loss: Is the Drug Dangerous?

Topamax for Weight Loss: Is the Drug Dangerous?


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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? How do real users rate and describe the effects of the drug for weight loss? And what do doctors think about using Topamax for weight loss?

In this article we’ll answer all of these questions and more as we review medical studies on Topamax for weight loss to give our take on whether the drug is likely or not to be effective for this outcome.

We’ll review side effects of the medication and feature reviews from individuals who tried Topamax for weight loss.

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.

But does Topamax cause side effects? We’ll review in the next section.

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.

But how do real users rate and describe their experience taking the drug? We’ll feature some unsponsored reviews in the next section.

Real People Try Topamax

A TikTok creator named Melissa Jones explains why she stopped taking Topamax even after losing 100 pounds:

@melissakjones Replying to @tired_ewok #fyp #topamax #memoryloss #majorweightloss ♬ original sound - Melissa Jones

A TikTok creator named Kendall Lauren shares some of the side effects she experienced from Topamax:

@kendall.lajewski Replying to @frogjorts 🥹🥹🥹 #foryoupage #fyp #chronicheadaches #migraines #topirimate #topomaxsideeffects ♬ original sound - Kendall Lauren

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.

The Doctors Show Discusses Topamax for Weight Loss

A segment on the popular “The Doctors” show discusses the rise of off-label Topamax for weight loss use, as well as the risk, and is only 5 minutes long:

Real Patients Review Topamax

Drugs.com is a resource that allows users to rate and describe the effects of prescription drugs they’re taking. 

The average review of Topamax for weight loss on the site is 6.6 out of 10, which interestingly is higher than the average review of the drug for seizures (5.8/10).

The top positive review comes from a user named “Sunny” who claims the weight loss was a favorable side effect after taking the drug to prevent migraines:

“After two days of Topamax, my appetite decreased noticeably. After a week, I had lost 7 pounds. By the time I had been on it for a month, I was down to 125 and still not hungry. Eating became something I thought I should do instead of something I HAD to do.”

The top negative review is written by a user named “Kate” who gives Topamax a 1-star rating and claims to have experienced side effects:

“This time I had side effects I was losing feeling in my hands and feet. My face would go numb…And it started to impact my memory. I almost immediately went off of it. And I’m still experiencing memory issues. I’ll be talking and can’t remember words in the middle of a sentence. Or I’ll tell someone something and then a couple of minutes repeat it because I forgot if I said it or not. Keep in mind I’m 21”

Is the Generic Version of Topamax 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 sells generic topiramate (25 mg) for $3.90 (link).

That’s a potential cost savings of 98% from using the generic version of the drug.

Our Clean Weight Loss Picks

There are food-based nutrients which have been shown in medical studies to be effective for weight loss.

Dietary fiber was shown in a medical review published in The Journal of Nutrition to cause 16 pounds of weight loss in 6 months 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.

MCT oil was shown in a meta-study to cause more than one pound of weight loss over 10 weeks. This equates to potential annualized weight loss of 6 pounds per year with less than one tablespoon's worth of MCT oil per day.

Bulletproof MCT Oil is our top MCT oil product, because the only ingredient is MCT oil derived from coconuts. and it currently costs only $15.50 for over a month's worth of product.

Ginger intake "significantly decreased body weight" according to a 2019 meta-study on ginger and weight loss that analyzed data from 14 clinical trials.

Pique La Ginger is our top ginger product, because it's an organic tea in convenient crystallized form, and all that's needed is to pour the powder into a glass and add hot water.

All three of the products mentioned in this section are entirely free of additive ingredients that we consider to be unhealthy.

Stay up-to-date on our research reviews

Conclusion

Topamax is a seizure medication that’s not approved by the FDA for weight loss.

The drug has been shown in some clinical trials to cause weight loss, but using a medication off-label may increase patient risk, and taking Topamax for weight loss seems illogical given that there are FDA-approved weight loss drugs.

Topamax can cause mild side effects like dizziness and fatigue, and more severe side effects like memory impairments and eye disorders.

Many of the online patient reviews we came across while researching this article mentioned personal experiences of side effects.

While the daily dosing range of Topamax for seizures tends to be over 200 mg, the daily dosing range for weight loss in the clinical trials we cited in this article was under 200 mg.

For patients considering Topamax, we would recommend speaking with your doctor about the generic topiramate instead, because it should be equally effective and may be significantly cheaper.