Hi everyone, I've been put on topamax to hopefully assist with weight loss as am obese and am really struggling with food. I've just titrated up to 75mg (25 in morning and 50 at night) and have so far found no changes in appetite and no weight loss. I realise weight loss is only a possible side effect, but I was so hopeful about this drug helping me! My question is, have people found that appetite suppression starts at a certain dose? Or do u think its too early? OR am I just one of those for whom topamax isn't working? Thankyou :)
Topamax weight loss side effect: dosage?
Question posted by Jess6702 on 15 Nov 2014
Last updated on 11 April 2023 by WildcatVet
This question has also been asked and answered here: Does topiramate cause weight loss?
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85 Answers
WildcatVet
11 April 2023
"Very common (10% of users): Weight decreased
Common (1% to 10% of users): Anorexia, decreased appetite, weight increased"
"Weight loss is not dose dependent as each individual will respond differently to the drug. Typically dosages can range from 25mg to 200mg/day. The lowest possible effective dose is recommended due to moderate to severe side effects."
"In the clinical trials of Topamax those who lost weight lost an average of 2.3% of their beginning body weight. "
Blonde Bomb
11 April 2023
My Dr said the dosage has to be high in order to lose weight. I'm 54, 5'6", was 336 lbs. I had already gone through 2 gastric lap band and 1 gastric sleeve surgeries, you have to follow the diet and use the surgery as a tool or it won't work. I was sent to this shrink that wouldn't prescribe Phentermine (different Dr. $100 office visit $20-30 meds) but told me about Topamax for weight loss. She said on a high enough dose your body stops hunger cravings so we tried. I take 200 mg twice a day. Side effects: very few cravings, I eat 0-2 small meals a day (and when I say small I'm talking 1/2 a taco, side salad, half a grilled cheese, 1 piece of med pizza thin crust), I try to get protein in. The worst part of Topamax is the constant dry mouth and thirst for water. I drink close to 100 ounces a day, I ALWAYS have my water bottle.
I get such cotton mouth that I can't swallow, can't move my lips because they're stuck to my teeth lol. You're always peeing so know where the nearest bathroom is. I started at 336 lbs and in 1 1/2 years with NO exercise I'm down to 151 lbs. From a size 26/28-10/12, this drug has been a life saver. I went from suicidal thoughts to actually living a skinny person life in a fat prejudice world.
Jenn8675309
11 Feb 2023
I was put on Topamax in August 2020 for migraines. I started with 25 mg at night. The next morning, my soda was flat, even the thought of food made me nauseated, the taste of everything was so bland, and I had absolutely no appetite. On top of that, I had the whole gamut of side effects, tingling in my toes/fingers/nose/lips especially when experiencing temperature swings, brain fog and trouble recalling words, and I stopped sweating completely (which is a problem in Arizona in the summer). I had to keep a food log to make myself eat at least enough calories to function, otherwise I would average 500-600 a day. I was 240 lbs. I was dosed up to 100 mg over the course of a month and stayed there for a year. In that time, I lost 30 lbs, my migraines went from 2-3 non migraine days a month to 3-5 migraine days a month. Near the one year mark, instated having break through migraines more frequently again and was increased to 150 mg.
I'm still at that dose and as of 2/3/23, I'm down to 160 lbs and 3-5 migraines a month. I still can't feel carbonation until it hits my throat, I put hot sauce on most everything I eat because food is still extremely bland, and I still get the tingles but the brain fog is gone.
billysmit555
3 July 2020
If we take a look overstudies held to evaluate the efficacy of Topamac for weight loss, then there remain some concerns regarding its long term safety. The drug may cause trouble, sometimes serious side effects in individuals using it for weight loss. A doctor or a health care expert can prescribe the correct dosage of the medicine, therefore, it is best to use it under the guidance of a doctor. It is not considered as the first-choice treatment for weight loss in individuals with eating disorders. Topamac is a prescription medicine for adults with seizures and it can reduce the frequency of migraine headache in children. It causes weight loss and become problematic for those who are underweight or have even normal weight.
kittenmew
5 June 2020
So, when it comes to Topamax you need to look at the pros and the cons. I usually take 200mg at night, and I am supposed to take 100mg in the morning, but if I take 100mg in the morning I am an absolute nitwit. I can tolerate the side effects from the several hours of sleep, but I cannot take this during the day. This is something my neurologist and I have been going through iterations of dosages, and seeing what I can handle. I've been on it for 12 years, and I cannot state that it has any weight benefits, although I've had a friend that stated that she was looking forward to some of those benefits, but I do not know how one drug can make so many people so eager to try just because of possible weight factors. I get it, it seems like a miracle pill, but don't get trapped in a state of stupor.
Tonipepper
30 Jan 2020
Hi everyone, I was placed on Topamax because Epilim made me so fat I could barely walk but what I was not told was that Topamax only works for six months. After that I gained all my weight back again. I have never been taken off Topamax though, that was eight years ago and it still works for headaches.
twinkie62
12 Sep 2019
It only worked for me while I was taking metformin for my type 2 diabetes. I lost 80lb. When I went off the metformin my appetite came back and slowly the weight did too.
Suziegirl2
9 Feb 2019
I have been on Topamax over 10 years for a seizure disorder. I was also a diabetic and was being treated by a new diabetic specialist. I weighed 205 lb and had a lot of health issues at that time. He switched me from my previous seizure medicine to topamax at 75 mg at night time. He never mentioned weight loss was a possibility but over the next 5 years I lost 50 lb. without really changing my eating or exercising very much. When I happened upon this site, I was very surprised to see that it is used for weight loss. Maybe because I wasn’t on at least 100 mg it wasn’t looked at as a weight loss product.
Rachellep30
8 Feb 2019
I take 50mg 2 times a day for migraines. With it I was taking vitamin B12 which helps with metabolism. My body doesn't absorb B12 properly so I have to take the shots once a month and a multi vitamin daily. When I first started it in 2016 it took only about a month and the weight started to fall off. In I'll say about a year's time I had lost 100 lbs. Now I have gained 40lbs and am having trouble losing it. I'm still on Topamax so I guess it just depends. I don't know I am eating different than I was so that could be the issue. Also my sister takes Topamax has been for years for seizures she takes 100mg 2 times a day and has seen no weight loss. I think it just effects everyone diffently.
Dedevaughn
8 Feb 2019
Since I answered this question originally I have been put on Trokendi. It is basically topamax in a sustained release pill. I still can maintain my weight because it somewhat reduces my appetite but doesn't obliterate it! It does help my headaches some. I'm still getting 3 to 4 headaches a week but they're not as intense. On the 19th I'm getting this ganglion numbing thing where they go up in your nose with a swab and touch something with this medicine that numbs this thing called the ganglion. It's supposed to prevent headaches for 6 months, the types of headaches I get, anyway. We'll see if that helps but I hope I stay on the Trokendi. I lost quite a bit of weight in October when I had thrush and couldn't eat for almost 4 weeks. Even through Thanksgiving and Christmas I didn't gain it back.
I am considered underweight right now, after having been obese or morbidly obese for 40 years it's kind of nice for them to tell you you're a little underweight. It's nothing that they're going to worry about it at 140lbs! The main reason they say that is because of all the loose skin I have on my abdomen. They say I have 20 to 30 lb loose skin so that means I effectively weigh 110-120lbs at 5'8" tall. I am only very thin from the waist down, but I still wear a size 4 jeans. That's not that thin considering there are 3 sizes smaller than that now. Used to it was the second smallest size and wasn't as big as it is now!
CurlyQTW69
6 Feb 2019
I have started on Ozempic 6 weeks ago after being on every drug for appetite suppression. Thankfully my research in learning that I have Leptin Resistance and my PCP finally listening to me my life has changed drastically. Give it a shot, literally.
Rachellep30
6 Feb 2019
I have been on Topamax since 2016 for migraines. I take 50mg twice a day. I have lost 100lbs since I started taking it. Now in the last 4 months I have gained about 30lbs back but I think that's just poor eating and no exercise. But when I started taking it within a month the weight just started falling off with no change in eating habits and little exercise. I also had the issue with things tasting funny. I still have that issue. I also suffer from hand and feet tingling. It gets so bad sometimes I almost can't stand it.
Deborah Totten
6 Feb 2019
I noticed it a little at 100 mg when I was at about 290 lbs I then moved it to 200 mg. I had no problems going from 100mg to 200mg with no titrating.
LKB37659
6 Feb 2019
Hi, I have taken topamax for years and I have found that my best and fastest weight loss was when I took 150 mg at night. 6x25mg pills. It took me about 2 months to lose 43 pounds. I got several kidney stones (side effect), memory loss, and trouble speaking to people. My blood pressure bottomed out, I spent several nights in icu. Now I take 2 per night but they do not help with weight loss, they are to control my migraines. I also have to take potassium citrate to control kidney stones.
MigraineMilly
27 Jan 2019
The dosage amount can be different for everyone but the most profound effect is really at a minimum dosage of 100mg.
The first effect is that you notice you’re extremely thirsty and water tastes AMAZING and you don’t want to drink anything but water. Soda tastes flat and gross. Sweet and salty things will be overly sweet and salty that you really have to force yourself to eat them, if you pay attention to these things and stop yourself then you can choose to eat other things like fresh foods which taste way better. You also don’t get hungry. If you only eat when you’re hungry and stop when you’re full you will loose weight but if you don’t pay attention to your body you won’t loose weight on Topamax. Also doing exercise really speeds up the weight loss. I lost 40 pounds in 6 months.
Related topics
topamax, side effect, weight, dosage, food
Further information
- Topamax uses and safety info
- Topamax prescribing info & package insert (for Health Professionals)
- Side effects of Topamax (detailed)
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