Comparing Contrave vs Topiramate

For Obesity I am 56yo woman, 405 lbs (not a typo), 5'9" tall. I find in thus forum that most people don't have the amount of wright to lose as I do yet I am hopeful. I started Contrave June 8th 2017 and have lost 11lbs. Soon I'll be up to 3 tabs/day. I find that it is helping somewhat yet I still am craving fast food. I am following a low carb diet with no exercise yet. I hope that the higher dose will help with the cravings more. Side effects for me have been lethargy and some nausea. I plan on continuing this med in hope that I finally can resolve my food addiction.

For Obesity I just started on my 4th week of taking Contrave. This drug was recommended by my therapist due to being a compulsive eater and the mild antidepressant benefit. I was already on a low cal low carb meal plan and doing food journaling but wasn’t losing weight cause of the stress eating. The first week was a learning experience. The first and second day I learned that if you eat something fatty then you will get sick no matter what time you took the pills. Your body will reject fatty foods. I think that is why people suffered from headaches and nausea. I have not had a problem since I cut out those foods. If I ate too much or ate even though my brain said not too then I would feel like I was having a panic attack. I do have a very active job and I sometimes walk. I lost nothing the first week and over the last two weeks I lost 6 pounds. My goal is to lose 50 pounds.

For Migraine Prevention I have been on Topiramate for over 4 years for migraine prevention, and in the very beginning was great. Went from 20+ migraines a month on a 50 mg dose to less than 5 with very few side effects (coke tasted bad, I drank water) no big deal. Now I’m up to 300mg a day and since then I’ve had kidney stones, major tingling in hands/feet, severe back pain, dry eyes, and migraines at least 4 days a week on top of other side effects. I don’t know what to do. I’m hoping it’s just the medicine doing this.

For Migraine Prevention I have been on Topamax for a little over a year now to treat severe migraines. I started from 25 mg and slowly went up to 150mg. I used to get 3-4 migraines a week and now they are down to maybe once a month, if that. For that it has been a life saver, but there are a few side effects. The tingling in the hands and feet went away completely after a few weeks on the final dose. but the mental fog is a side effect that stayed. I still have trouble concentrating and remembering things, especially details & sometimes have trouble finishing a sentence. I am a student and I use to get A's all the time and now I can study for hours and will not get anything higher then B. To me this is a price to pay for being migraine free.