Phentermine plus Topiramate for Weight Loss?

Many candidate weight-loss drugs have been abandoned because they caused unacceptable side effects. However, drug combinations in moderate doses might have synergistic weight-loss effects with fewer adverse effects.

U.S. researchers randomized 2487 obese adults (body-mass index, 27–45 kg/m²) with two or more comorbidities to combinations of phentermine (an FDA-approved weight loss drug) and topiramate (an antiseizure drug that causes anorexia and weight loss) at low or high doses or to matching placebo once daily for 56 weeks. All patients were counseled about changing their diets and lifestyles. Previously diagnosed mild depression or antidepressant prescriptions were reported for 17% of patients.

Forty-three percent of placebo patients and …