Phentermine may be used short-term as an aid to weight loss; however, it can be addictive and tolerance may develop to its weight-losing effects, rendering it less effective with time. Topiramate 25mg be prescribed either alone or in combination with other medications for the treatment of certain and topiramate of epilepsy, or best 2mg xanax bars difference between phentermine be given for the prevention of migraines. For Weight Loss I have been taking this medication for many years.

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To investigate the safety, tolerability and efficacy of combination phentermine and topiramate therapy for maintenance of weight loss. Design, setting and patients: Retrospective audit of patients attending the Austin Health Weight Control Clinic who were dispensed phentermine—topiramate between 22 January and 16 July and after reaching a target weight by following a very low energy diet VLED. Data collection continued until July Main outcome measures: Number of patients who ceased pharmacotherapy; phentermine difference between of use of and topiramate 25mg types and numbers of adverse and topiramate 25mg and mean weight and blood pressure measurements at the initial visit, the end of the VLED and the xanax like drugs over the counter observation during pharmacotherapy.

Data were available for patients who were dispensed phentermine—topiramate; 61 patients ceased combination pharmacotherapy before the end of the data collection period, 41 due to adverse effects eg, paraesthesia, cognitive changes, dry mouth and depression. The mean duration of use of pharmacotherapy was 10 months. And topiramate 25mg 30 patients who continued and topiramate 25mg phentermine—topiramate, the mean duration of pharmacotherapy was 22 months and the mean weight decreased by 6.

Phentermine—topiramate therapy was not well tolerated; more than half of the patients in our study stopped taking it because of adverse effects, and more than half trazodone vs valium for anxiety attacks the adverse events reported were ascribed to topiramate. However, in those able to continue with pharmacotherapy, the combination was efficacious for both maintenance of weight loss and ongoing weight loss.

The global obesity epidemic has not spared Australia; The US Food and Drug Administration recently approved combination phentermine and controlled-release topiramate xanax 0.5 high dose doses ranging from 3. Phentermine is a sympathomimetic agent that induces serotonin, noradrenaline and dopamine reuptake inhibition, suppressing appetite.

Topiramate causes weight loss; 4 its postulated effects include increasing energy expenditure, decreasing energy efficiency and decreasing caloric intake. In Australia, phentermine is available for use as short-term monotherapy for obesity and topiramate is available for treatment of epilepsy, migraine prophylaxis and treatment of neuropathic pain. The efficacy topiramate 25mg and phentermine—topiramate has been assessed in Phase III trials, with a maximal weight loss of Recent studies have shown that phentermine monotherapy is relatively safe; it has no significant effects on blood pressure and heart rate 8 and it does not induce psychological dependence or addiction.

Phentermine—topiramate therapy is used for maintenance of weight loss in selected adults who attend the Austin Health Weight Control Clinic, a tertiary centre obesity service. We aimed to investigate its safety, tolerability and efficacy. They then receive dietary advice on reintroduction of carbohydrates. Those who have active ischaemic heart disease or severe hypertension, and those who are concurrently taking antidepressants, are not offered pharmacotherapy.

Women of childbearing age are counselled about the teratogenicity of topiramate, which causes cleft lip and palate in the fetus. Patients are seen monthly during the weight loss phase and at the physician's discretion during the weight maintenance phase usually 3-monthly. We used the Austin Hospital's pharmacy records to identify patients dispensed phentermine—topiramate between 22 January and 16 July Patient data sex and age; weight, height and blood pressure measurements; and qualitative data regarding potential adverse effects and reasons for ceasing pharmacotherapy were collected from the Weight Control Clinic's electronic database.

Patients who did not attend the clinic for more than 6 months were defined as being lost to follow-up. We analysed the data at four time points: Time 1, the initial visit; Time 2, the end of the VLED; Time 3, the time point during pharmacotherapy at which the nadir weight measurement was taken; Time 4, the time point during pharmacotherapy at which the xanax and grapefruit juice dangerous weight measurement was taken.

For those lost to follow-up, weight measurements at Time 1 were carried forward to calculate mean final weight and tramadol or medical marijuana for pain relief final BMI, an intention-to-treat analysis. For those who ceased pharmacotherapy before the end of the data collection period, we analysed mean weight 3—6 months and 12—18 months after cessation, using available weight data.

Paired t tests were used to compare weight and blood pressure data between time points. During the study period, patients were dispensed phentermine—topiramate. Data for patients were analysed as no data were available for the remainder. Patients were initially severely obese Box 1and the mean duration of pharmacotherapy was 10 months median, 6 months; interquartile range, 13 months. Mean weight decreased by Using intention-to-treat analysis, mean final weight and mean final BMI Pharmacotherapy was ceased by 61 patients 41 ceased due to adverse effects ascribed to pharmacotherapy, and 20 for other reasons [eg, three started antidepressant therapy, one was planning to get pregnant and one had laparoscopic banding]30 patients continued pharmacotherapy, and 12 patients were lost to follow-up.

A total of 67 "and topiramate 25mg" effects were reported among 52 patients, the most frequent being paraesthesia, cognitive changes and depression adverse phentermine and between 25mg difference topiramate of topiramate and headaches, dry mouth and palpitations adverse effects of phentermine Box 2.

Seven and topiramate 25mg these 30 patients had adverse events: Between Times 1 and 2, mean weight for these patients decreased by By Time 4, overall, the mean weight decreased by a further 6. However, for men, the decrease in weight between Time 2 and Time 4 was not significant. No significant changes were observed in blood pressure measurements for these patients data not shown. Weight data after ceasing pharmacotherapy were available for 51 patients who ceased pharmacotherapy Box 5.

By the end of pharmacotherapy, the mean weight decreased by a further 3. At 3—6 months after cessation, mean weight had increased by 3. By 12—18 months after cessation, mean weight increased by a further 1. Mean weights at and after cessation of pharmacotherapy were statistically different to mean weights at Time 1 but not statistically different to mean weights at Time 2. To our knowledge, this is the first study of phentermine—topiramate use for maintenance of weight loss in Australia.

The lack of a dose titration schedule and the use of a non-controlled release formulation in our study may have also contributed to the difference between phentermine than expected number of adverse effects ascribed to topiramate. Limited data were available for patients who ceased phentermine—topiramate therapy. Mean weight at 12—18 months after cessation was not significantly different to weight at and topiramate 25mg end of the VLED, but was significantly lower than the initial weight.

However, this result represents only 28 patients and a short duration of follow-up. The major limitation of this study is the lack of a control arm. The most common reasons for patients not being offered pharmacotherapy were antidepressant use and active ischaemic heart disease. This meant that the patients who were not offered pharmacotherapy were not suitable and topiramate 25mg comparators.

Combination pharmacotherapy with phentermine and topiramate may soon be available in Australia. The results of our study show low tolerability. However, for those who are able to continue phentermine—topiramate, the combination appears to be efficacious not only for maintenance of weight loss but also for ongoing weight loss. Publication of your online response is subject to the Medical Journal of Australia 's editorial discretion. You will be notified by email within five working days should your response be accepted.

Basic Search Phentermine hcl 30 mg reviews search search. Use the Advanced search for more specific terms. Title contains. Body contains. Date range from. Date range to. Article type. Author's surname. First page. Short reports. Guidelines and statements.

Narrative reviews. Ethics and law. Medical education. Volume Issue 4. Combination phentermine and topiramate for weight maintenance: Med J Aust ; 4: Topics Nutritional and metabolic diseases. Abstract Objective: Results During the study period, patients were dispensed phentermine—topiramate. Discussion To our knowledge, this is the first study of phentermine—topiramate use for maintenance of weight loss in Australia. Received 9 Decemberaccepted 3 June Australian Bureau of Statistics.

Profiles of health, Australia, — ABS, ABS And topiramate 25mg. OpenDocument accessed Jun Inequalities in bariatric surgery in Australia: Med J Aust ; Long-term persistence of hormonal and topiramate 25mg to weight loss. N Engl J Med ; A 6-month randomized, placebo-controlled, dose-ranging ambien remains in system of topiramate for weight loss in obesity.

Obes Res ; Obesity Silver Spring ; Effects of low-dose, controlled-release, phentermine plus topiramate combination on weight and associated comorbidities in overweight and obese adults CONQUER: Lancet ; Am J Clin Nutr ;