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Migraine Preventive Medication Topamax for Weight Loss

As most of us who have taken the antiseizure medication Topamax for migraine prevention already know, it can take a knock out punch to your appetite. As researchers have recognized this they’ve started testing it as a weight loss medication.

An investigational weight loss pill called Qnexa combines the medications Topamax and Phentermine. Phentermine is one of the most widely-used medications for weight loss in the United States. An investigational trial has shown an average weight loss of 22 pounds in one year for patients taking Qnexa and lower blood pressure, cholesterol and blood glucose levels. Compared to patients assigned to diet and exercise counseling alone, patients taking Qnexa experienced significantly greater weight loss. However, we already know Topamax alone carries with it some serious side effects.

Topamax has been associated with extreme nausea (likely the reason so many people lose weight on it), heart problems, cloudy thinking, lethargy and an increased risk of birth defects in babies born to women taking it. Infants born to women taking Topamax have been found to have an increased risk of cleft lip or palate. In fact, the Food and Drug Administration (FDA) recently rejected Qnexa’s application for approval as a weight loss medication because of these risks, particularly the heart risks and birth defects. While weight loss is undoubtedly a serious medical issue, the FDA did not believe the benefits of Qnexa outweighed the significant risks for the target population. However, researchers said there were no birth defects among the 34 babies born to women taking Qnexa in this trial and that based on these results they plan to reapply for FDA approval before the end of 2011.

Although the researchers said the weight loss results carried over into the second year for patients taking Qnexa, they acknowledged there is no way of knowing whether it is safe for patients to consume Qnexa for the long term or for a life time. They don’t believe the weight loss would necessarily sustain itself if the patients stop taking Qnexa. They also pointed out other weight loss drugs that have shown short term success did not turn out to be safe enough for long term use and that this will be the most important bar any potential weight loss drug has yet to overcome.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

Effects of low-dose controlled-release phentermine plus topamirate combination on weight and associated comorbidities in overweight and obese adults

Comments

  • Cheri Lynn Thornton-Conner
    8 years ago

    Topomax didn’t work as well for me, either. I didn’t lose much in the way of weight and wasn’t happy with the side effects. It DID lessen the severity of many of them but it has lost its effectiveness. I am sensitive to aspirin and motrin (GERD) and have elevated liver numbers, so I’ve gotten off of it. However, my migraines are LONG term and I’ve been working with some biofeedback efforts along with non-medicine efforts (shutting off lights over my desk, wearing sunglasses. All in all, I get through most days.

  • Bryan Pate
    8 years ago

    look into oxyelite, i dont know if it help with the migraines but it will help with the weight loss, the first time i took it i lost about 14 pounds in 24 days without working out, look into to it mom love you

  • Micki Bowers
    8 years ago

    topomax made me suicidal. definitely not a good choice for me!

  • Teri Tyler Eddy
    8 years ago

    No one has mentioned the hair loss associated with Topamax. I used to have a full, thick head of hair, and now I have maybe half what I had before using T’max. It worked for migraines management (they weren’t gone, but manageable) but I’m not sure I’m willing to be bald the rest of my life. I’m off it now, hoping the hair loss will subside, then I’ll reevaluate. Just taking Relpax or Frova and Fioricet now. No prophylaxis for the first time in decades. We’ll see.

  • Cheryl ShadowBoxing Smith Gabourel
    8 years ago

    I took TOPAMAX from about 1998 to 2004. It seemed to be the “Miracle Drug” (for me) at the time. My migraines lessened and I even loss about 40 lbs. Great right? Not! I began to have liver failure. They attributed my problem to the TOPAMAX. I was taken off the drug and got better, although I gained back about 80 pounds. If it works for you…good, but please be vidulent in having your doctor monitor your liver and kidney functions. There are NO miracle drugs. This is MY experience and I only am speaking for myself.

  • Shafone Williams
    8 years ago

    Thats good to share Cheryl and im glad you were able to come off the meds and get back healthy. It’s unfortuante that these drug companies can’t make anything without it ruining your life. It’s like making a decision to live or die with some of these meds and in some cases just cause you are alive dosen’t mean you are living

  • Cheryl ShadowBoxing Smith Gabourel
    8 years ago

    I agree Shafone Williams. To have the migraines is bad enough…but to risk damage to your vital organs knowing what studies have showed is sad. I have an under active thyroid & have been struggling with my weIght for years now. My weight ballooned up after I had my daughter (she’s 19 now) & I became really self-conscious. I was put on TOPAMAX for severe debilitating migraines & had no knowledge of the side effects. I will admit that I was pleased with it helping to lesson my migraines…the weight loss was a bonus, or so I thought. Then I loss so much weight I became weak and fainted several times. I was almost ematiated. One winter day I was at the hospital & caught a glimpse of my reflection…I was horrified. I had a black coat & scarf on and when I saw myself…I looked like “The Grimm Reaper.” I came off that medicine & even though I gained back twice as much weight, I have not been self-conscious about my weight since. I was just glad my organs were not permanently damaged & I just thank God that I am alive. I still suffer with severe debilitating migraines and a quite a few other health issues, but I have NO regrets of getting off that medicine.
    I hope my story may be of help to someone.

  • Cheryl ShadowBoxing Smith Gabourel
    8 years ago

    If it works for you…good, but please be vidulent in having your doctor monitor your liver and kidney functions with simple blood tests. It was originally prescribed for my severely migraines. The weight issue was never factored in. That side effect was ever discussed.

  • Shafone Williams
    8 years ago

    Unfortunately this is a drug with major side effects I smh at the people who want to use it for weight loss it’s not worth it

  • Amanda Pearce
    8 years ago

    I am currently on Topamax 75mg PM. this has helped with some of the confusion, memory loss. I also am recieving Botox injections every 3 mths. They are painful, but are controlling my migraines. Prior to my first treatment, I was avg. over 3 migraines a week. Now I avg. 1 every week and a half at the most. Acupuncture has also helped.

  • bill71
    8 years ago

    I am a caregiver for my wife has expirienced migraines since she was 14, all right sided. No family member has ever expirienced migraines. Then in March 2010 she was in an accident where now she has 2 different sources of migraines. Imitrex eventually was like taking candy so the Doctor prescribed Topamax and Maxalt. She also get lidocaine shots in her neck muscles every 3 weeks. She is unable to work,and I’ve had two bouts with cancer. As a caregiver and paramedic I can recognize the pre cursers before they hit. It’s almost looks like a CVA or TIA developing. Families sometime really don’t understand. There is two types of people, one who doesn’t have migraines and the other who does. The one who doesn’t has no clue of the pain. As her caregiver patience is really the primary assistance we can give.

  • Sheri Lee
    8 years ago

    What dose of Topamax were you getting these results at? Currently taking 50mg 2x a day for nerve pain and I don’t have any of the side effects mentioned….

  • Heather Reed
    8 years ago

    When I was on Topamax I was failing all me classes I couldn’t remember peoples names (even family members)I would stutter. This medication is horrible the side affects were not worth it. I started feeling like I was stupid and just could never think strait and get my message across.

  • Mary Ortis Creighton
    8 years ago

    I had the same thing happen. When I told my doctor I wanted to get off it, he laughed and said: “Well, if you could remember, I told you that was a side-effect.” He started weaning me off it, right away.

  • April Kenney
    8 years ago

    Is there an alternative to Topamax?

  • April Kenney
    8 years ago

    Thank you ~ I will do more research on alternative therapies and over the counter meds. I have tried other treatments over the years. I started with more natural treatments, pepperment, massage; when that didn’t work I reached out for medication, relpax, imatrix. In 2009 I had an auto accident, whiplash, worstened my migraines. After the 4th day of vomiting, sever, head, neck pain, I had to go to the ER for treatment. I started Topamax (generic brand) in November; the side effects shocked me. Confusion, couldn’t spell, remember names, make change, basic math, no sex drive, everything that is listed seems too happen! The Topamax stopped the vomiting, I have not been to the ER since I started the medication. I have had a struggle making the decision to stop taking 50mg AM and 50mg PM and riskviolent migraine attacks.

  • Amrita Bhowmick
    8 years ago

    Hi April, There are literally hundreds of migraine treatments, combination therapies, etc available. You and your doctor just need to find what will work best for you! You can read more about potential treatments, including prescription meds, over the counter meds, natural remedies, and complementary/alternative therapies here: http://migraine.com/migraine-treatment/

  • Carolyn Nelson Doherty
    8 years ago

    Topamax ruined my stomach for years after I went off it. Never got rid of the migraines. It took five years before I could eat almost normal again. Great for losing weight-if that’s how you want to do it. No appetite and everything goes right through you. Always in the bathroom.Even messed the sheets a few times. No way to live for me. My daughter took it at a higher dose and didn’t have near the trouble I did. Never know.

  • April Kenney
    8 years ago

    Abigail ~ I too am on the gereric brand of Topamax and suffer from side effects that include frequent migraines that limit my abilities. However, before taking medication I was vomiting and the migraines were soo intense I landed in the ER monthly.

  • Abigail Bristow
    8 years ago

    I am now on this drug it was actually my idea as I was formerly on really really bad drugs for my migraines, norco, fioricet and I wasn’t really happy with the results of them as I was still having migraines now I am on the generic topamax and I am now not sleeping or eating and I don’t have a weight problem at all. in fact I am fighting to stay over 100lbs I look as bad as I feel most days. I really thought that going on the topamax would help me get my migraines under control and I’d be able to go back to work and have a life again and instead it seems that it’s just getting worse still having migraines still really nauseated and can’t sleep or eat this is one neat drug.. but hey ast I don’t get dirty looks anymore from doctors when I am having a migraine and I tell them what am on or when people ask me about it and ask me what I am doing about it.that is however not really very fullfilling.

  • Abigail Bristow
    8 years ago

    I know I just don’t know what to do anymore so I am sticking with the topamax for now and I will stay at a 7 it sure does beat the 9 I have been at lately and just deal with it. there really isn’t anything else I can do. I am damned if I do and damned if I don’t either way I am in pain and the dr’s don’t really care either way. anyway talk at you later <3 U <3 abby

  • Sheri Lee
    8 years ago

    I also take Norco during the day and Fierocet at night, and while my primary care doc assures me that I’m not taking near enough to be an addict, you would think I was the worst of street users the way my pain managment doc talks to me. In one breath, he says that he doesn’t want me taking “those drugs” (I’m allergic to aspirin products, so we’re really limited) and in the next breath, he’s telling me that the “only way to treat the kind of pain you have is with medications.” er what??

  • April Kenney
    8 years ago

    I can confirm as well ~ I have lost 20lbs while taking the generic brand of Topamax. I would like to get off medication, but am a bit nervous about Migraines and all that comes with them coming back. I would like to hear from folks; after you have stopped taking Topamax did the migraines come back? How long did it take before they did? Did you need to go back on medication? For my health, I know I can address my weight gain and have, I am more concerned about what this toxic drug is doing to us! Is there another option? What is it?

  • Barbetta Reedy
    8 years ago

    When I was on topamax I still had migraines it didn’t stop them it slowed them down buy not stopping them. I was on it for 5 yrs when I started getting confused, not finishing my sentences, couldn’t concentrate, and the migraines came back like before I was on topamax after a yr I got off of the drug. Yes on good side effect was weight loss but the confusion wasn’t worth that. I am not on anything except for sumatriptan shots 6mg and I take 8 shots a month besides 8 days of other drugs for the migraines and laying down with a migraine. In a month’s time I have at least 16 migraines. They are no fun and I have had them now for 34 yrs.

  • Debbie Leasure
    8 years ago

    I agree, I lost over 50lbs in 2 years and when I went off gain it all back in 6 months. still going to gym as migrains allow and eating the same way.

  • Dawn Dawson Schell
    8 years ago

    Well, I can attest that Topamax kills the appetite, and helps with weight control. I went off it, and gained 25 pounds! It’s definitely not for everyone, though.

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