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Xenical plus Meridia plus Topamax causes men to lose 53-77 lbs
Tuesday, July 06, 2004 3:05 pm Email this article
Three men who were highly motivated to lose weight lost an average of 67 pounds using a combination of Xenical (orlistat), Meridia (sibutramine), and Topamax (topiramate) according to a paper from Free University in Berlin, Germany. 39-year-old woman lost 53 pounds
One man, who was 39-years-old, lost 53 pounds, dropping from 246 pounds to 194 pounds.
42-year-old woman lost 70 pounds
Aother man, who was 42-years-old, lost 70 pounds, going from 238 pounds to 167 pounds.
34-year-old woman lost 77 pounds
A third man, who was 34-years-old, lost 77 pounds, going from 253 pounds to 176 pounds.
Xenical alone for the first four months
First, Xenical (orlistat) was given alone at a normal dose of 120 mg three times a day.
The reason they started with Xenical, was to find patients who would be compliant with eating a low-fat diet, because if they did not, they would experience side effects. Three patients dropped out within the first 2 weeks because of unbearable diarrhea from the Xenical.
Patients had been advised to follow a balanced, low-fat diet of approximately 1,000 calories per day for 2 months prior to starting on the Xenical.
Side effects during the first week of treatment with Xenical included mild diarrhea, abdominal bloating, and oily anal discharge.
Meridia added after four months
After four months, Meridia (sibutramine) was added at a dose of 10 mg in the morning for three days, which was then increased to 15 mg in the morning.
Side effects during the first four months of treatment with Meridia included complaints of dry mouth, and one person was found to have borderline hypertension during one measurement (140/95 mmHg).
Topamax added after another four months
After another four months, Topamax (topiramate) was added.
The dose of Topamax was started at 25 mg per day and increased 25 mg per week up to a 100 to 300 mg per day, given either at bedtime or divided between morning and night, enough to give a subjective feeling of appetite suppression, and depending on the occurrence of side effects, or both.
Side effects reported after Topamax were initial dizziness, transient slight difficulties in speaking (aphasic difficulties), difficulties concentrating, and one patient reported a burning, itching, tingling sensation around the mouth (perioral paresthesia).
Maximum weight loss after 11 months
Maximum weight loss occurred after 11 months, at which time the Xenical and Meridia were stopped, but the Topamax was continued for an additional 11 months during weight maintenance.
Excellent weight maintenance
According to a graph included in the paper (Fig. 1 on page 522), the subjects appeared to gain back a little weight during the final eleven months while on Topamax alone—maybe 10 pounds or so, but this is just a very rough guess—but in general, the patients appeared to do an execellent job of maintaining their weight loss especially considering how much weight they had lost.
This study was the first to employ this triple drug therapy of Xenical, Meridia and Topamax.
Anghelescu I, Klawe C, Szegedi A. Add-on combination and maintenance treatment: case series of five obese patients with different eating behavior. J Clin Psychopharmacol. 2002 Oct, 22(5):521-24.
Ion Anghelescu, MD
Department of Psychiatry/UKBF
Free University Berlin
Eschenallee 3, D-14050
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