A review of topiramate and phentermine: a combined therapeutic approach for obesity

Effective treatment of obesity could reduce the burden of diseases primarily driven by excess body weight (e.g., Type 2 diabetes). At present, effective nonsurgical weight management tools are scarce. This paper reviews the investigational combination of phentermine, a weight-loss drug available for over half a century, and topiramate, an antiepileptic drug with known weight-loss effects, as a proposed anti-obesity intervention. The combination therapy achieves weight loss of a magnitude that meets the expectations of the US FDA along with improvement of some obesity-related risks. The safety profile is consistent with known adverse effects of individual constituents; cognitive and psychiatric adverse events were dose dependent. Other safety concerns include a small increase in heart rate and potential teratogenicity associated with topiramate.