Topamax is the brand name for topiramate, a medication approved for epilepsy and migraine prevention. Topiramate is sometimes used off-label for weight management, and it is also one component of the FDA-approved combination medication phentermine/topiramate extended release (Qsymia).
Topiramate can reduce appetite or change food preferences in some people. The degree of weight loss varies, and topiramate alone is not FDA approved specifically as a weight-loss medication.
Qsymia combines phentermine with extended-release topiramate and is FDA approved for chronic weight management in eligible patients. Taking topiramate alone is a different treatment strategy.
Possible side effects can include tingling, cognitive slowing, word-finding difficulty, fatigue, taste changes and mood symptoms. More serious risks and contraindications require medical review.
Topiramate-containing weight-management treatment requires careful pregnancy precautions because fetal exposure can cause harm. Patients who can become pregnant need specific counseling and monitoring.
Selection depends on medical history, migraine history, kidney-stone risk, medications, pregnancy potential, psychiatric history and other factors.
See our Weight Loss Medications guide for alternatives.
