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This medication can help you lose weight by reducing appetite and cravings.

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Branded names

Topamax®, Eprontia™, Qudexy®, Trokendi®

Conditions FDA-approved to treat

Seizures and preventing migraines

Benefits for weight loss

Reduce appetite

The results are in...

  • How it works

    Although topiramate is FDA-approved for treating seizures and preventing migraines, it is also commonly used by leading specialist obesity clinicians and weight clinics off-label to help aid with weight loss by reducing appetite and cravings.

  • Form and dosing

    Topiramate typically comes in a tablet form and extended release capsules (25 mg, 50 mg, 100 mg and 200 mg) and sprinkle capsules (15 mg and 25 mg) and extended release sprinkle capsules (25 mg, 50 mg, 100 mg, 150 mg, 200 mg) and liquid form (25 mg/ml). Dosing instructions vary according to weight, tolerability and other factors and should be discussed with your healthcare provider.

  • Common side effects
    • anorexia
    • weight loss
    • dizziness
    • fatigue or drowsiness
    • difficulty with concentration and
    • psychomotor slowing
    • speech difficulty
    • nervousness
    • tingling or prickling sensations
    • abnormal vision
    • fever

What are doctors saying?

“Topiramate is used for many medical conditions such as migraines, seizures, and nerve pain but also is a helpful off-label option for weight loss which works by reducing hunger and cravings. Topiramate can be prescribed alone, in combination with other medication, or sometimes to counteract the weight gain potential of certain medicines.”

— Dr. Rekha Kumar, Chief Medical Officer at Found

“The FDA has not approved Topamax as a weight loss supplement, but taking it for other conditions such as migraines may result in weight loss as a side effect.”

— MedicineNet

“Topiramate has a substantial effect on weight loss, at least comparable to the weight loss that other anti-obesity drugs induce," Kramer said. "We have so few pharmacological options for the treatment of obesity that I believe topiramate can be a useful tool together with diet and exercise."

— Science Daily (Caroline Kramer, MD, PhD, endocrinologist at Clinic Hospital of Porto Alegre in Brazil)

“Studies have found that about 6–17% of people who take Topamax will lose body weight (National Library, 2021). One review of studies found that people with obesity who took Topamax for at least four months lost an average of about 12 pounds more than the placebo group (Kramer, 2011).”

— Ro Health Guide

Medical Disclaimers

Topiramate is only FDA-approved to treat seizures and prevent migraines. Prescribing medications are up to a medical provider’s discretion and may not be appropriate for everyone.

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Topiramate warnings


Before using topiramate, tell your healthcare provider about your medical history, especially if you have:

  • narrow angle glaucoma and
  • nearsightedness
  • kidney problems, such as kidney stones
  • liver problems
  • depression or thoughts of suicide
  • lung or breathing problems
  • metabolic acidosis
  • high blood ammonia levels
  • long-term diarrhea
  • low body temperature
  • a diet high in fat and low in carbohydrates, aka a ketogenic diet
  • brittle bones

Topiramate may cause some people to sweat less. It is recommended to avoid alcohol and stay well hydrated while taking this medication.This drug may make you dizzy or drowsy or impair your judgment. Please do not drive, operate heavy machinery, or perform any hazardous task until the effects of topiramate are known to you. For anyone taking diabetes medications, please have a discussion with your prescribing clinician prior to taking topiramate as your diabetes medications may need to be adjusted as you lose weight.

Topiramate may also cause birth defects (particularly there is a risk of cleft lip and/or palate and low birth weight). Topiramate may cause breakthrough bleeding. DO NOT take topiramate if you are planning to become pregnant or if pregnant or breastfeeding.

Side effects information

Many people experience no side effects while taking topiramate. Some of the most common side effects (but not extremely frequent) are:

  • anorexia
  • weight loss
  • dizziness
  • fatigue or drowsiness
  • difficulty with concentration and psychomotor slowing
  • speech difficulty
  • nervousness
  • tingling or prickling sensations
  • abnormal vision
  • fever

Additional side effects include:

  • difficulty with memory
  • changes in taste
  • diarrhea
  • numbness
  • nausea
  • abdominal pain
  • upper respiratory tract infection
  • hair loss
  • changes in mood/suicidal thoughts

These symptoms may subside after the body adjusts to the medication.

Drug interactions

As with other medications, topiramate can interact with alcohol, marijuana and certain medications, including antiepileptic drugs, CNS depressants, oral contraceptives, lithium, other carbonic anhydrase inhibitors, hydrochlorothiazide, pioglitazone and amitriptyline. Please consult the pharmaceutical packaging for a full list of side effects, warnings, interactions and additional information.

To report suspected adverse reactions to topiramate contact the FDA at 1-800-FDA-1088 or

In case of emergencies, please call 911 or go to the nearest emergency room.