This is a combination medication for obesity. It consists of PHENTERMINE, which has been on the market for many years. The second drug is TOPAMAX, somewhat newer, but on the market long enough to be generic.
Anytime a patient tries to lose weight, he or she should always try lifestyle changes first. Medications should just be an adjunct to help out.
The reason is that, if you can not make life long changes in lifestyle, you are doomed to gain every ounce back. (How many of my readers actually know anyone who lost 20 or more pounds and actually kept it off?)
Don’t believe some of the negative reviews about phentermine that have been in the papers lately. It is SAFE and I have never had a patient become addicted to it in over 30 years of practice. Yes, it can cause insomnia and elevated blood pressure, but that is why I only prescribe it under strict supervision. An article recently came out that reviewed its safety profile and found it to be safe in seniors and heart patients (who are stable). Another article followed patients on it for two years and found a marked significance in those who were able to keep the weight off, even if they were not able to lose anymore pounds.
Topamax is an anti seizure drug that we use mainly for headaches, depression and chronic pain. By accident, researchers found that many patients ALSO lost weight while taking it. The biggest drawback is that there is a dose dependent relationship to confusion and memory loss that is reversible when the dose is either lowered or discontinued. The worst side effect I have seen so far was a patient who had an eye problem, that resolved when the medicine was stopped.

The major points to remember are:
1. LIFESTYLE CHANGES SHOULD BE THE NUMBER ONE PRIORITY (HEALTHY EATING AND EXERCISE)
2.IF, MEDICATIONS ARE INDICATED, I WOULD START WITH PHENTERMINE FIRST, THEN ADD TOPAMAX ONLY IF NECESSARY
3.ALL TREATMENTS MUST BE UNDER MY STRICT SUPERVISION OR I WILL NOT PRESCRIBE THEM

Sometimes, diet, exercise and will power are just not enough to help one lose weight. There are many drugs and supplements available to help. Unfortunately, most are either not FDA approved nor are they safe (HCG).
At our practice, we have been using Phentermine for over 30 years with a lot of success. It is very inexpensive. At one time it cost $5.00/month until a fake shortage was conjured up in the late 1990’s, but the price is still affordable in the mid $20.00 range.
Whenever we place a patient on Phentermine, we require two things from our patients:
 
          1. Adopt a healthier lifestyle. (Use this time to learn how to eat healthy)
          2. Start an exercise program. (Learn to build muscle and burn fat)
 
Even though many patients will develop tolerance to phentermine, studies have shown that, even after two years, those using it still had lower weights then those who stopped it. The risks of cardiovascular side effects were no different then placebo, even in senior citizens.
 
Lately, we have been adding Topamax to Phentermine and have been able to increase weight loss in some of our patients. Topamax is actually an anti-seizure drug but can be very effective in helping patients lose weight. It was only by mistake that the medical world discovered patients on it were losing weight. We use it mainly for chronic pain and migraines.
 
Both Phentermine and Topamax are safe for long term use, but like any other medications, side effects can be seen.  The most common side effect with Phentermine is nervousness and insomnia. Topamax may cause drowsiness and confusion. These side effects are reversible when the medications are stopped. Please note that, medicine is an art and not a science. Results are NEVER guaranteed as we can never predict how the human body will react.
 
These medications may or may not be appropriate for you. Only your PHYSICIAN can tell you if it is appropriate to use.
 
In our practice, our patients must be seen on a monthly basis to get their prescriptions renewed.