Effects of phentermine and topiramate: A Synthesis of Findings from 26 Studies

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Original Abstract of the Article

Major Research Findings

Several studies have found that a combination of phentermine and topiramate can be effective in treating obesity. 23 、 9 、 1 、 17 、 12 、 19 、 16 、 13 、 15 、 11 、 14 、 10 、 5 、 8 、 24 、 18 、 21 、 20 This combination can help people lose weight and improve metabolic problems related to obesity. 1 、 16 However, there is a risk of birth defects if phentermine and topiramate are taken during pregnancy, so the FDA requires a Risk Evaluation and Mitigation Strategy (REMS) for this combination. 6 Additionally, some studies have reported an increased risk of heart disease. 7 、 22 There are also reports of gastrointestinal problems associated with phentermine and topiramate. 25 、 26

Benefits and Risks

Benefits Summary

Phentermine and topiramate, when combined, can help people lose weight. 23 、 9 、 1 、 17 、 12 、 19 、 16 、 13 、 15 、 11 、 14 、 10 、 5 、 8 、 24 、 18 、 21 、 20 They may also improve metabolic problems related to obesity. 1 、 16 Some studies suggest that they could improve physical function. 20 Some research has also shown a potential benefit in improving high blood pressure. 18

Risks Summary

Taking phentermine and topiramate together during pregnancy can increase the risk of birth defects. 6 Additionally, there are reports of an increased risk of heart disease. 7 、 22 There are also reports of gastrointestinal problems associated with this combination. 25 、 26

Comparison of Studies

Commonalities among Studies

Most studies have shown that the combination of phentermine and topiramate is effective in helping people lose weight. 23 、 9 、 1 、 17 、 12 、 19 、 16 、 13 、 15 、 11 、 14 、 10 、 5 、 8 、 24 、 18 、 21 、 20 Additionally, they have all agreed that taking phentermine and topiramate together during pregnancy can increase the risk of birth defects. 6 However, the findings differ on the risks of heart disease and gastrointestinal problems. 7 、 22 、 25 、 26

Differences among Studies

The findings differ on the risks of heart disease and gastrointestinal problems. 7 、 22 、 25 、 26 Some studies have reported a higher risk of heart disease, while others have not. 7 、 22 Some studies have reported risks of gastrointestinal problems, while others have not. 25 、 26 Additionally, some studies have found that phentermine and topiramate could improve high blood pressure, while others have found they could worsen it. 18 These discrepancies may be due to factors like study design and participant characteristics.

Consistency and Contradictions in Findings

Although many studies indicate that the combination of phentermine and topiramate can be effective for weight loss, 23 、 9 、 1 、 17 、 12 、 19 、 16 、 13 、 15 、 11 、 14 、 10 、 5 、 8 、 24 、 18 、 21 、 20 , further research is needed to determine more definitive conclusions regarding its impact on heart disease, gastrointestinal problems, and high blood pressure. 7 、 22 、 25 、 26 、 18

Points to Note When Applying This in Real Life

While the combination of phentermine and topiramate may be effective for weight loss, it's crucial to remember that it can increase the risk of birth defects if taken during pregnancy. 6 Additionally, there are reports of an increased risk of heart disease and gastrointestinal problems. 7 、 22 、 25 、 26 Therefore, it's essential to consult with your doctor before taking this combination and understand the potential risks and benefits.

Limitations of Current Research

There's a lack of research evaluating the long-term effects and safety of the combination of phentermine and topiramate. 19 Furthermore, more research is needed to determine more definitive conclusions regarding its impact on heart disease, gastrointestinal problems, and high blood pressure. 7 、 22 、 25 、 26 、 18 Additionally, due to the potential for significant individual differences, more research is necessary. 24

Future Research Directions

Studies evaluating the long-term effects and safety of the combination of phentermine and topiramate are needed. 19 More research is also required to gain a more definitive understanding of its impact on heart disease, gastrointestinal problems, and high blood pressure. 7 、 22 、 25 、 26 、 18 Furthermore, research should consider individual differences in response to this treatment. 24

Conclusion

While the combination of phentermine and topiramate has shown potential for weight loss, it is important to remember that it can increase the risk of birth defects if taken during pregnancy. 6 There are also reports of an increased risk of heart disease and gastrointestinal problems. 7 、 22 、 25 、 26 Consult with your doctor before taking this combination and carefully weigh the risks and benefits. 2 Further research is needed, particularly studies that examine the long-term effects and safety of this combination and account for individual differences. 19 、 24

Literature analysis of 26 papers
Positive Content
22
Neutral Content
1
Negative Content
3
Article Type
3
1
1
15
24
1.

Drugs to treat obesity: do they work?

Author: KimSarah

Weight loss
Continual drug use
Side effects

Obesity treatments have expanded since 2012 with four new drugs: lorcaserin, phentermine/topiramate, naltrexone/bupropion, and liraglutide. These drugs aim to control hunger and satiety, leading to 3-10% weight loss on average. However, each drug has unique side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

2.

Pharmacological Management of Obesity: A Century of Expert Opinions in Cecil Textbook of Medicine.

Author: ManuPeter, LăcătuşuCristina-Mihaela, RogozeaLiliana M, CerneaSimona

Inefficient treatment

The pharmacological management of obesity has remained inefficient over the past century, with a limited impact on body mass index, prevalence of medical complications, quality of life, and work potential.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

3.

Past, Present, and Future of Pharmacologic Therapy in Obesity.

Author: RodríguezJosé E, CampbellKendall M

Obesity management
Adverse effects
High cost
Misuse potential

Obesity medications include antidepressants, stimulants, fat blockers, and diabetes drugs. Only lorcaserin and orlistat are approved for long-term use. Many are expensive and have misuse potential, and none are approved for pregnant or breastfeeding women.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

7.

A Rare Case of Phentermine-Induced Nonischemic Cardiomyopathy.

Author: DamaniDevanshi, HassanMariam, MahapatraSwati, PrakashSwathi, AlhaririSara, BiesJared, TrivediBhavi, EdwardsBrian P

Heart failure
Phentermine use

This case report highlights the potential for phentermine to precipitate heart failure, even in a young, relatively healthy person.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.

Language : English

10.

Pharmacotherapy of obesity: Available medications and drugs under investigation.

Author: PilitsiEleni, FarrOlivia M, PolyzosStergios A, PerakakisNikolaos, Nolen-DoerrEric, PapathanasiouAimilia-Eirini, MantzorosChristos S

Cardiovascular benefit
Metabolic benefit
Weight loss
Weight regain

Obesity affects over 500 million people globally. While lifestyle changes are crucial, they often fail to achieve long-term weight loss. FDA-approved medications like orlistat, lorcaserin, and others can aid in weight loss (5-10%), leading to improved cardiovascular and metabolic health. This review discusses existing and future anti-obesity drugs.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

11.

A randomized, placebo-controlled crossover trial of phentermine-topiramate ER in patients with binge-eating disorder and bulimia nervosa.

Author: SaferDebra L, AdlerSarah, DalaiShebani Sethi, BentleyJason P, ToyamaHannah, PajaritoSarah, NajarianThomas

Binge eating treatment

This study investigated the efficacy and safety of phentermine/topiramate ER (PHEN/TPM-ER) for binge eating disorder (BED) or bulimia nervosa (BN) in a crossover randomized controlled trial.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.

Language : English

12.

Study protocol and rationale for a randomized double-blinded crossover trial of phentermine-topiramate ER versus placebo to treat binge eating disorder and bulimia nervosa.

Author: DalaiShebani Sethi, AdlerSarah, NajarianThomas, SaferDebra Lynn

Enhanced efficacy
Improved tolerability

Qsymia, a medication for obesity, is being investigated as a potential treatment for bulimia nervosa and binge eating disorder. Up to 50% of patients with these disorders remain symptomatic despite treatment, highlighting the need for new therapies. This study protocol focuses on evaluating the safety and efficacy of Qsymia in a Phase I/IIa clinical trial.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.

Language : English

13.

A randomized, double-blind, placebo-controlled, pharmacokinetic and pharmacodynamic study of a fixed-dose combination of phentermine/topiramate in adolescents with obesity.

Author: HsiaDaniel S, GosselinNathalie H, WilliamsJenna, FarhatNada, MarierJ F, ShihWinnie, PetersonCraig, SiegelRobert

Weight loss

The combination of phentermine and topiramate effectively reduces weight in obese adolescents. This study evaluated the pharmacokinetics and pharmacodynamics of this combination in adolescents, reporting weight loss and adverse events.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

14.

Benefits of weight loss of 10% or more in patients with overweight or obesity: A review.

Author: TahraniAbd A, MortonJohn

Weight-related complications improvement

This study reviews the benefits of significant weight loss (at least 10%) in individuals with obesity. Most studies achieving this level of weight loss used bariatric surgery or intensive lifestyle modifications, highlighting the potential benefits of achieving larger weight loss goals for managing obesity-related complications.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

15.

Precision Obesity Treatments Including Pharmacogenetic and Nutrigenetic Approaches.

Author: SolasMaite, MilagroFermin I, Martínez-UrbistondoDiego, RamirezMaria J, MartínezJ Alfredo

Obesity treatment
Drug interaction
Side effects

This review summarizes FDA-approved medications for obesity treatment, including orlistat, lorcaserin, liraglutide, phentermine/topiramate, and bupropion/naltrexone, highlighting phentermine/topiramate as the most effective. It also discusses other factors relevant to obesity management, such as comorbidities and personalized treatment strategies.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

16.

Centrally Acting Agents for Obesity: Past, Present, and Future.

Author: CoulterAnn A, RebelloCandida J, GreenwayFrank L

Obesity treatment

Obesity is now recognized as a chronic disease. This review looks at how central nervous system-acting drugs are used to treat it. Current drugs like phentermine/topiramate, bupropion/naltrexone, lorcaserin, and liraglutide are discussed, along with promising future drugs like tesofensine and semaglutide.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

18.

Obesity-Induced Hypertension: New Insights.

Author: AntzaChristina, StabouliStella, NatsisMichalis, DoundoulakisIoannis, KotsisVasilios

Blood pressure reduction
Weight loss
Increased blood pressure

Weight loss is crucial for managing hypertension in overweight and obese patients. While lifestyle changes can help, not everyone can achieve this without medication. Newly approved anti-obesity drugs have varying effects on blood pressure, with some reducing and others increasing it.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

19.

Long-Term Efficacy and Safety of Anti-Obesity Treatment: Where Do We Stand?

Author: TakYoung Jin, LeeSang Yeoup

Cardiometabolism
Weight loss

Obesity is a chronic condition with metabolic and cardiovascular complications. While lifestyle changes are important, achieving long-term weight loss is difficult. This article discusses the benefits of using medication in conjunction with lifestyle interventions for managing obesity.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

20.

The effects of weight-lowering pharmacotherapies on physical activity, function and fitness: A systematic review and meta-analysis of randomized controlled trials.

Author: JobanputraRishi, SargeantJack A, AlmaqhawiAbdullah, AhmadEhtasham, ArsenyadisFranciskos, WebbDavid R, HerringLouisa Y, KhuntiKamlesh, DaviesMelanie J, YatesThomas

Improved physical function

Weight loss medications improved self-reported physical function in individuals with obesity, with a standardized mean difference of 0.27 (95% CI: 0.22 to 0.32). However, the impact on physical activity and objectively measured fitness remains unclear due to limited data.

Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

21.

Obesity: The New Global Epidemic Pharmacological Treatment, Opportunities and Limits for Personalized Therapy.

Author: MilanoWalter, De BiasioValeria, Di MunzioWalter, FoggiaGiuseppina, CapassoAnna

Drug therapy options

Obesity rates are increasing globally, with projected increases by 2050. Drug therapy is an important option for treating obesity when lifestyle changes and surgery are limited.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

22.

Cardiovascular effects of antiobesity drugs: are the new medicines all the same?

Author: CataldiMauro, CignarelliAngelo, GiallauriaFrancesco, MuscogiuriGiovanna, BarreaLuigi, SavastanoSilvia, ColaoAnnamaria,

Improved heart contractility
Lower blood pressure
Reduced atherogenesis
Weight reduction
Impaired cardiac adaptation
Impaired endothelial protection
Increased blood pressure
Increased heart rate

This review examines the cardiovascular effects of new anti-obesity drugs. Bupropion/naltrexone has mixed effects, while liraglutide appears to offer cardiovascular benefits. Phentermine/topiramate's impact is uncertain, and lorcaserin has minimal direct cardiovascular effects. More research is needed to determine the overall cardiovascular safety and efficacy of these drugs.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

23.

A review of the metabolic effects of controlled-release Phentermine/Topiramate.

Author: KiortsisDimitrios N

Metabolic effects
Weight loss
Adverse events

Phentermine/topiramate controlled-release (Qsymia®) has recently been approved for chronic weight management. This article reviews the available clinical evidence on its weight loss, metabolic effects, and adverse events.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

24.

Selection of Antiobesity Medications Based on Phenotypes Enhances Weight Loss: A Pragmatic Trial in an Obesity Clinic.

Author: AcostaAndres, CamilleriMichael, Abu DayyehBarham, CalderonGerardo, GonzalezDaniel, McRaeAlison, RossiniWilliam, SinghSneha, BurtonDuane, ClarkMatthew M

Obesity interventions
Phenotype-guided treatment
Weight loss
Antiobesity medications
Obesity

A pragmatic clinical trial of 312 patients with obesity found that a phenotype-guided approach was associated with 1.75-fold greater weight loss after 12 months compared with a non-phenotype-guided approach. The mean weight loss was 15.9% in the phenotype-guided group and 9.0% in the non-phenotype-guided group.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

25.

Risk of de-novo inflammatory bowel disease among obese patients treated with bariatric surgery or weight loss medications.

Author: KochharGursimran S, DesaiAakash, SyedAslam, GroverAbhinav, El HachemSandra, Abdul-BakiHeitham, ChintamaneniPreethi, AounElie, KannaSowjanya, SandhuDalbir S, SinghSiddharth, ShenBo, LoftusEdward V, DulaiParambir S

Reduced IBD risk

Bariatric surgery and weight loss medications, excluding orlistat, were associated with a lower prevalence of de-novo inflammatory bowel disease (IBD) compared to obese controls, suggesting that obesity and ineffective management of obesity are risk factors for IBD.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

26.

Efficacy of adjuvant weight loss medication after bariatric surgery.

Author: Nor HanipahZubaidah, NasrElie C, BucakEmre, SchauerPhilip R, AminianAli, BrethauerStacy A, CetinDerrick

Halted weight regain
Improved weight loss
None mentioned

Adjuvant weight loss medications were effective in halting weight regain and achieving weight loss in patients who underwent bariatric surgery.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Observational StudyResearch that observes and collects data on participants' behavior and outcomes in their natural state, without intervention.

Language : English

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