Appetite loss topiramate

Among the adverse effects of topiramate are reduced appetite and weight loss, and this has been put to use in the treatment of binge eating in an open study in 13 patients (6). Nine patients had a moderate or better response, two had moderate or marked responses that subsequently diminished, and two had a mild response or none. Neurological adverse effects were the most common. Three patients discontinued topiramate because of adverse effects, and two resumed at a later date without significant recurrence. 

In an open study of topiramate 50 or 100 mg/day in 30 patients with migrainous vertigo, 19 had paresthesia, 11 fatigue, 8 memory and concentration problems, 14 reduced appetite, and 4 weight loss [281 ]. Four withdrew at the end of the first month because of adverse reactions. 

All the available evidence for the use of topiramate as monotherapy in patients with newly or recently diagnosed epilepsy has been examined in a systematic review of three randomized, double-bUnd, controlled trials which recruited more than 1000 patients [302 ]. The most common adverse events associated with topiramate 50-500 mg/day generally occurred early in the course of treatment and were nervous system-related effects headache (15-25%), dizziness (12-19%), fatigue (11-23%), somnolence (10-17%), anorexia (8-10%), insomnia (7—10%), and hyperesthesia (5— 10%). Adverse events that were likely to have been related to the carbonic-anhy-drase activity of topiramate (e.g. paresthesia, changes in serum bicarbonate) were frequent (13-35%) but were not usually considered clinically relevant Renal calculi occurred infrequently (1%). The most frequent adverse events during maintenance therapy were headache (20%), reduced appetite (11%), and weight loss (11%). 

In 12 patients (3-35 years) diagnosed with Dravet syndrome who received fenfluramine as an add-on therapy, a slight thickening of one or two heart valves was detected in two patients. Loss of appetite was reported in two patients, who were both on combination therapy with topiramate, a drug also known to reduce appetite. Additionally, fatigue was reported in two patients, and excessive somnolence in one patient [56 ]. 

---