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Dr Marlowes Weight Loss - Charlotte

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Topamax (Topiramate)

How does Topamax help me lose weight?
Topamax works in multiple ways to help you lose weight, but you must change your behavior in response to those effects. In non-technical terms, it works on neurons in the brain to (1) decrease the addictiveness of food and also to (2) make you feel full sooner. It is great for people who are addicted to carbs, because it removes the pleasure you get from carbs. When that happens, you need to stop eating the carbs you no longer enjoy. It has been known to make foods like soda taste flat and wine/beer taste bad. You can get drunk, but you no longer get a happy buzz. They did a one-year study of alcoholics joining AA who were seriously trying to quit drinking and the ones who took Topamax did a significantly better job of staying clean and sober than the alcoholics who took placebo. Also, you get full on much less food. When that happens, you need to stop eating, because if you keep eating, you will feel bad reflux.

What are some side-effects?
Many patients experience side-effects from this medicine. Patients can have side-effects that are very annoying, but they usually slowly go away over a period of 2-5 weeks while you continue the medicine. You can prevent most side-effects by taking Euphasia two capsules twice daily to chase away the side-effects. Euphasia is available at our office. Sometimes, the side-effects don’t lessen and you must discontinue the Topamax entirely, and then the side-effects do go away. You may experience numbness/tingling of your fingers or toes, drowsiness, fatigue, and loss of appetite. You may temporarily experience difficulty concentrating, memory difficulties, difficulty finding the right word, diarrhea, constipation, mood disturbances/improvements, or sleep disturbance. Less commonly, Topamax can cause kidney stones, reflux if you overeat, or upper respiratory infections. If any of these happen, please let us know so we can discuss the risks and benefits of continuing the Topamax. If any vision changes happen, which is very rare, seek medical attention immediately. Don’t become pregnant while taking Topamax because Topamax is known to cause birth defects. This handout is not a substitute for the FDA’s handout, so please read the entire FDA insert.

What results have you seen at The Institute?
One patient said, “Dr. Marlowe, this is the first time I have been able to drive past the ‘Hot Now’ Krispy Kreme sign.” He lost more than 70 lbs on Topamax. Another said, “I haven’t had a soft drink in 6 months. Yesterday, I tried a Coke and it tasted TERRIBLE – like river water. That medicine is great.” Another said, “This is WONDERFUL. I didn’t know what it felt like to never have a migraine. I’ve had them my whole life. Now I know what it feels like to be free.” Yet another, “My head felt funny. I felt disoriented. I didn’t know where I was for a few seconds. My tongue felt heavy. It was awful.” Someone else, “People said I slurred my words.” A different patient, “I couldn’t say the word I knew – words were always on the tip of my tongue.” Or: “I can’t remember stuff and I was foggy, but it was worth it and I tell my friends who I send to Dr. Marlowe to stick with Topamax, because I went from 210 to 155 lbs.”

How do I take Topamax?
Take one pill at bedtime for 10 days. The next 10 days, take one in the morning and one at night. The next 10 days, take one in the morning and two at night. If you develop mild side-effects, continue increasing the dose. If the side-effects are tolerable, don’t increase the dose, but start the Euphasia described above. If the side-effects are intolerable, please discontinue the Topamax and call our office. If the side-effects create an emergency, call 911.

Why don’t you just prescribe Qsymia?
Qsymia is the combination of phentermine and Topamax into one pill. I rarely prescribe it. First, if you need lower or higher doses of phentermine or Topamax, you can’t do it with Qsymia. The doses are not adjustable. When Topamax and phentermine are separate pills, we can adjust either one. Second, Qsymia is far more expensive and could cost you 10 times as much. Lastly, if you started a combination-pill like Qsymia and broke out in an allergic rash, you wouldn’t know which ingredient you were allergic to, so you wouldn’t be allowed to take either medication ever again.