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Results: All 5 patients had a good response to treatment at a mean topiramate dose of 195 mg/day (range, 100â375 mg/day). All patients lost a substantial amount of weight on topiramate treatment. The average weight loss was 22 lb (10 kg; range, 8â56 lb [4â25 kg]). No patient discontinued topiramate because of side effects. We started topiramate at 25 to 50 mg daily and conducted a gradual titration in increments of 25 mg. The slow titration may have been responsible for the lack of significant side effects.
The 7.5/46 mg Qsymia dosage group achieved statistically greater weight loss than was seen with the higher doses of phentermine and topiramate monotherapy. The higher Qsymia dose also induced greater weight loss than either placebo (P<0.05) or the combination's individual components at all time points (P<0.05). This translated into an absolute weight loss of: 1  8.3 kg (18.3 pounds) in the lower-dose Qsymia group. 2  9 kg (19.8 pounds) in the higher-dose Qsymia groups. 3  1.5 kg (3.3 pounds) in the placebo group. 4  5.3 kg (11.7 pounds) in the low-dose phentermine group. 5  6 kg (13.2 pounds) in the high-dose phentermine group.