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Danvers, MA
A 45-year-old male asked:

how long should it be before you start losing weight on topamax (topiramate) and what dose do you need for it to start?

3 doctor answers6 doctors weighed in
Dr. Frances Dyro
Neurology 54 years experience
Weight loss: Is variable in amount and time. This is a seizure drug with many side effects and must be monitored. Starting dose is usually 25mg twice a day for a week, increasing to 50 mg twice a day. Weight loss is actually a side effect caused by the drug's changes in the body chemistry. Some have reported up to 20 pounds in a month.
Dr. Bennett Machanic
Neurology 52 years experience
Unfortunately, the most loss usually occurs in those who are already thin or underweight.
Sep 25, 2013
Dr. Becky Parks
Neurology 34 years experience
No guarantee: Tpm is indicated for the treatment of certain types of seizures in children and adults, and for the prevention of migraine headaches in those that have them frequently. Not everyone loses weight on tpm. Standard dosing for migraine is 50 mg twice daily; for seizures the dose is higher. Tpm does not have an fda-indication for weight loss. Many possible side effects so wudn't use unless indicated.
Dr. Bennett Machanic
Neurology 52 years experience
Not so easy: In actuality the weight loss on topamax (topiramate) is really modest, perhaps 3-5 lbs in most folks who experience this, but the greatest loss occurs in those who were thin or underweight to start, and those who are obese or overweight will likely see minimal or no weight loss.

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Last updated May 10, 2018
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