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How does Trokendi XR help with weight loss?

Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on Aug 22, 2025.

Official Answer by Drugs.com

Trokendi XR (topiramate) extended-release capsules are approved by the FDA for the preventive treatment of migraine headaches in patients 12 years and older and for seizure control in certain forms of epilepsy in patients 6 years of age and older. Immediate-release topiramate (Topamax) has been shown in studies to lead to weight loss as a side effect when used for both seizure control and migraine prevention.

Trokendi XR has not been studied in Phase 3 clinical studies, but the manufacturer states it is expected that it would produce a similar side effect profile as immediate-release topiramate.

In studies with immediate-release topiramate, weight loss was reported in both children and adults. In general, weight loss may occur in 6% to 17% of patients, and may worsen as doses are increased. Weight loss and loss of appetite (anorexia) were two of the most commonly reported side effects.

Related: Does topiramate cause weight loss?

Related questions

Is topiramate approved for weight loss?

Topiramate, typically used for seizures and migraine prevention, is available in an extended-release capsule known as Qsymia (phentermine and topiramate) that is approved for weight loss. Phentermine is an appetite suppressant (anorexiant) with properties similar to the amphetamine drug class. It is classified as a schedule 4 controlled substance by the DEA.

Qsymia is used along with diet and exercise to treat people who are either obese, or overweight with other risk factors like high blood pressure, high cholesterol or type 2 diabetes.

Related: Weight Loss and Diet Pills: Options to Know

This is not all the information you need to know about Trokendi XR (topiramate extended-release) XR for safe and effective use and does not replace your doctor's directions. Review the full product information here, and discuss this information and any questions you have with your doctor or other health care provider.

References

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How fast does Trokendi XR work for migraines?

You should see your migraine headaches subside within the first month of taking Trokendi XR, but not all patients have a response to the medicine. About 50% of patients have been shown to respond to Trokendi XR in clinical trials. On average, most patients see about 2 fewer migraine headaches per month when using Trokendi XR. Your dose will be slowly increased over a 4-week period. Continue reading

Does Trokendi XR cause hair loss?

Yes, topiramate, the active ingredient in Trokendi XR has been shown to cause hair loss (alopecia) in clinical studies, but it is not a common side effect. Alopecia with topiramate has been reported in 1% to 4% of children ages 6 to 16 years of age, and in 3% to 4% of patients older than 16 years of age. Trokendi XR is an extended-release form of topiramate. Continue reading

Does Topamax (topiramate) cause hair loss?

Yes, topiramate has been shown to cause hair loss in studies, but it is not a common side effect. Hair loss (also called alopecia) has been reported in 1% to 4% of children ages 6 to 16 years of age, and in 3% to 4% of patients older than 16 years of age. Higher daily doses (400 mg/day) of topiramate were associated with greater rates of hair loss than lower doses (50 mg/day) in both age groups.

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