Topiramate
( brand name Topamax )
Zonegran prevents seizures by inhibiting the chemical channels for
sodium
and
potassium
on
nerve cells.
This makes nerve cells less active. Zonisamide also seems to affect the chemical nerve signals called
serotonin
and
dopamine.
By affecting serotonin and dopamine, it may decrease a person's appetite.
Topamax also blocks sodium nerve channels. In addition, it increases levels of a nerve signal called
GABA.
This signal makes nerves calm down and become less active. Topamax has
a few other actions that help it to treat seizures. How it actually
causes weight loss is not as well known.
Pros Both of these drugs have been studied specifically to see if they cause weight loss, which they do. Cons Both
of these drugs have several side effects. Some of topiramate's side
effects are a tingling sensation, sleepiness, trouble with memory, and
difficulty concentrating. Some of zonisamide's side effects are
dizziness, confusion, difficulty concentrating, and speech problems.
Both may cause kidney stones. There
are only small studies on the weight loss effects of these medicines.
This makes it more difficult to make a good recommendation on their use
for weight loss. Some experts even recommend not using these medicines
for weight loss. This is understandable with all their side effects. Other comments In studies done on weight loss with these medicines, a low calorie diet was given along with the medicine. Diet and exercise are the mainstays of weight loss plans.
Return to Home Page or Weight Loss Drugs.
It
is important you discuss any weight loss or exercise plan with your
doctor. Only you and your physician can decide what is best for you.
Some people have certain conditions that prevent them from doing all
exercises, and goal body weights may be different for different people.
You need to discuss all these things with your physician before
starting any weight loss or exercise program. In addition, the dosage
of any medicine may be different if it is used for weight loss and not
its FDA approved indication. You should also discuss this with your
doctor. This article was written by John Vickery, MD.
References
Ann Intern Med 2005;142:525-531
“Drug therapy of Obesity” UpToDate version 15.3
"Pharmacology of antiepileptic drugs" UpToDate ver 15.3
Treatment Guidelines from the Medical Letter 2003;1:101-106
Journal of the American Medical Association 2003;289:1820
Epocrates Online @ http://www.epocrates.com accessed on 3/4/2008
| 
