How to Take Topamax for Weight Loss

By Monica Miller

Topamax is the brand name for the oral drug topiramate, an anticonvulsant medicine used in the treatment of epilepsy. It is also commonly prescribed to prevent migraine headaches in adults. A common side effect of taking Topamax is weight loss, induced by the drug's tendency to suppress the appetite. According to Bruce Goldfarb in the January 2005 edition of the American Diabetes Association's journal Doc News, clinical studies show that nearly three-quarters of the drug's users experienced weight loss, anywhere from 4 to 16 percent of their starting weight. There are, however, a number of adverse side effects associated with Topamax, including memory problems, insomnia, anxiety, dizziness, fatigue, tingling sensations and taste distortion, all of which must be carefully considered before choosing this drug as a weight loss aid. If you are still interested in trying Topamax, and all other methods of losing weight have not worked for you, then here's what to do.

Talk to your doctor. Topamax is a prescription-only medication, so the only way to get it is through a licensed physician. Be ready to state your argument about how other, more traditional, methods of losing weight have not worked for you in the past, and that you are aware of the side effects of Topamax but are willing to try it anyway. While some doctors will deny your request, arguing that the Food and Drug Administration (FDA) has not approved Topamax as a weight loss medication, others will be open to it, knowing that the FDA's lack of approval only means it can't be advertised as a weight loss product by its manufacturer. Doctors often prescribe medicines for "off-label" use--that is, for conditions that a drug is not primarily intended to treat. See if your doctor is open to the idea.

Tell your doctor about any prescription or non-prescription medications, including birth control pills, that you are currently taking, because Topamax could interfere with their effectiveness.

Follow your physician's directions exactly if he or she does prescribe Topamax for your weight loss intentions. Do not think if you take a larger dose than prescribed, you will lose more weight more quickly. You will only open yourself up to the possibility of more severe side effects, which in turn will most likely cause your doctor to cancel your treatment.

Take Topamax with or without food. If you've been prescribed tablets, don't bite into them, as you will immediately notice a bitter taste. If you have capsules, you can either swallow them whole or open them and sprinkle the medication over a spoon of some sort of soft food like applesauce that can be swallowed without chewing.

Drink plenty of fluids while taking Topamax, because the drug raises your susceptibility of developing kidney stones. Drinking lots of water and other non-caloric fluids is necessary in any weight loss effort, so this is something you should be doing anyway.

Limit your alcohol intake while on Topamax to guard against aggravated side effects. Also be cautious when performing tasks that require mental alertness such as driving.

Report any and all side effects to your doctor right away. Some, such as fatigue, are more likely to develop with higher doses of Topamax. Others may appear regardless of the dosage. While some will disappear on their own after the first eight weeks or so, it is still important to report them to your doctor so he or she can evaluate whether you should stay on Topamax.


Open a Topamax capsule by holding it upright (look for the word "top") and carefully twisting off the clear half of the capsule. You can then sprinkle the contents onto a spoon of soft food and swallow.

Store your Topamax in an airtight container at room temperature. Keep it away from moisture and light.


Be particularly vigilant during hot weather or when intensely exercising, because these factors raise the potential for serious side effects from Topamax. Make sure to drink plenty of fluids and to wear light clothing. If you notice decreased sweating, seek an air-conditioned or cooler area and stop any vigorous activity. If you experience headaches, dizziness, drastic mood changes, or your body temperature is above normal, seek medical attention.

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