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  • Zonegran reduces sweet cravings, causes weight loss, says Dr. Jay Piatek


    Posted by .(JavaScript must be enabled to view this email address)
    Monday, July 19, 2004 4:03 pm Email this article
    Dr. Andrew (Jay) Piatek says that Zonegran (zonisamide) may be the new and improved Topamax (topiramate), causing weight loss, but with fewer side effects. Here is information that he gives his patients about Zonegran (zonisamide). Corrections as of July 19, 2004 are shown in blue.

    “There is a new medication that I also wanted to let you know about called Zonegran (zonisamide). Zonegran is an exciting breakthrough in medications for weight management.

    Zonegran used in other countries for 10 years

    Zonegran has been used in other countries and on the market internationally for ten years and in this country for over two years.

    There are over one million patient experiences; it has also been given to children.

    Zonegran has the same indications as Topamax

    It has actually been used for the same indications as Topamax. It is used to treat seizures (indication), as well as back pain, nerve pain, headaches, restless legs and bipolar disease (off label).

    Zonegran has fewer side effects than Topamax

    It appears to have fewer side effects than Topamax and also has very few contraindications.

    It has no interactions with other medications and has a very low side-effect profile.

    No effect on birth control pills or glaucoma

    It does not affect birth control pills and does not cause the glaucoma that has been associated rarely with Topamax.

    Zonegran weight loss study in 2003

    A weight loss study was published in JAMA in April 2003 with patients using Zonegran.

    [Click here to read a summary of the Zonegran study.]

    The study found that the patients that took the Zonegran lost weight, and it was well tolerated.

    Most patients liked the medication as it tended to stop binge eating and made sweets as well as carbonated beverages undesirable.

    As the medication is void of serious side effects, only one participant dropped out of the study due its side effects.

    Approximately 33% of the study participants complained of fatigue; therefore, I do give it at night as it should help you sleep.

    Zonegran is rarely associated with kidney stones

    It is rarely associated with kidney stones in previous stone formers. If you have a history of kidney stones, you should be cautious and drink lots of fluids with it.

    Do not take Zonegran if you have a sulfa allergy

    Note: You should not take it if you have a sulfa allergy.

    Dr. Piatek gives Zonegran with phentermine

    I have recently started giving it to quite a few patients (

    over 1,000

    ) and have been very impressed—especially when used in conjunction with a stimulant medication such as Adipex (phentermine).

    It seems to be additive, that is, adding Zonegran probably causes an additional 3-4 pounds per month of weight loss.

    In the case of side effects, increase the dose slowly

    The capsule can actually be opened and the dose titrated [increased slowly].

     

    Zonegran comes in 25 and 50 mg capsules.

    I typically do this in the rare event of a side effect.

    Dr. Piatek starts with 100 mg pill every other night, then every night

    I have patients start off with

    one-25 to 50 mg pill, then increase the dose slowly up to 100 mg

    every other night for one week and then increase to one every night.

    In many cases, the higher the dose, the more the appetite is suppressed.

    We typically increase on a monthly basis

    until the appetite is suppressed—usually 100-200 mg.

    It is obtained through a pharmacy, and most insurance companies do pay for Zonegran as it is used to treat those illnesses I mentioned earlier.

    ———

    ADDITIONAL COMMENTS ABOUT ZONEGRAN FROM DR. PIATEK

    Zonegran being used for peripheral neuropathy (nerve pain)

    A lot of the neurologists in my area are using Zonegran for peripheral neuropathy (nerve pain).

    [For someone with pain,] the key to losing weight for this patient is lower the pain level which, will lower levels of

    cortisol [stress hormone]. It is also important to use any medications to control the pain that may be more associated with weight lose then weight gain. Certainly patients also sleeping better at night have a more better cortisol level which, does assist with weight lose as well.

    For those who have gained weight taking Neurotin, add Zonegran to control the pain, then slowly wean off Neurotin

    [For someone who has gained with taking Neurontin (gabapentin),] I typically start patients either on Topamax or Zonegran at low dose, while they continue taking Neurontin.

    Each month increasing the Zonegran until there is no pain.

    Then I slowly wean them from the Neurontin.

    Zonegran great for sweet cravings; the new and improved Topamax

    Zonegran is outstanding for sweet cravings, pop drinking and binge eating. It seems to be a new and improved Topamax.

    ———

    As noted above, the above information is from Jay Piatek, M.D.

    Articles on the same subject can be found here:


    COMMENTS

    On Jul 20, 2004 at 8:36 am robert skversky m.d. wrote:

    . . . . .

    an additional caveat in reference to zonegran. although not reported as yet in this country there have been rare reports of steven-johnson syndrome during clinical trials in japan. I inform my patients that if they develop a rash (of any type) to immediately stop the medication regardless of whether there may be some other more plausible etiology. dr s

    On Jul 20, 2004 at 10:10 am Larry Hobbs wrote:

    . . . . .

    Dr. Skversky,

    Thanks for pointing this out.

    A 1985 study which was testing Zonegran (zonisamide) for epilepsy noted that one person "had to be withdrawn after 18 days because of mild Stevens-Johnson syndrome." (Wilensky et al, 1985).

    REFERENCE

    Wilensky A, Friel P, Ojemann L, Dodrill C, Mccormick K, Levy R. Zonisamide in epilepsy: a pilot study. Epilepsia. 1985 May-Jun, 26(3):212-20.

    Here is the link to abstract for that study.

    http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=4006880

    -----

    Another article reported that a 14-year-old girl treated with Zonegran (zonisamide) also developed the syndrome.

    REFERENCE

    Yoshioka M, Ishiguro N, Ma X, Kikuta H, Kodaira J, Itoh T, Kobayashi K. Protein-losing cytomegalovirus gastritis in a patient with stevens-johnson syndrome. Digestion. 2002, 65(4):234-37.

    -----

    Here is information about Stevens-Johnson syndrome from various websites.

    ---

    Stevens-Johnson syndrome is a rare, life-threatening, reaction of the skin caused by a hypersensitivity to a drug.

    In the U.S. and Europe, it occurrs in approximately 2-3 people per million each year.

    Stevens-Johnson syndrome is an acute skin condition in which the patient develops multiple red and purple blotches on the skin of the palms, soles, backs of the hands and feet and the "upper surfaces" of the arms and legs.

    There may also be raised bumps, tiny blisters and large blisters.

    The characteristic lesion of Steven Johnson syndrome is the target lesion.

    Target lesions have a dark, raised center surrounded by a pale ring, which in turn is surrounded by a red ring.

    The resemblance to a bull's eye accounts for the name "target lesion."

    Stevens-Johnson syndrome is a severe form of erythema multiform.

    The mucous membranes (of the mouth, airway, eyes, urethra and vagina) are afflicted with vesicles and bullae.

    Fever, chills, headache and an all-around uncomfortable feeling (malaise) accompany these lesions.

    Recovery is usually slow, depending on the extent and severity and the presence of complications, and may take 3 to 6 weeks.

    Skin lesions heal usually heal without scars.

    A person who experiences Stevens-Johnson syndrome caused by a drug should not be re-exposed to that drug because it is possible that it may cause an even more severe reaction the next time.

    REFERENCE

    Fritsch P, Sidoroff A. Drug-induced Stevens-Johnson syndrome/toxic epidermal necrolysis. Am J Clin Dermatol. 2000 Nov-Dec, 1(6):349-60.

    -----

    Here are references to two review papers for anyone wanting more information about Stevens-Johnson syndrome.

    REFERENCES

    Araujo O, Flowers F. Stevens-Johnson syndrome. J Emerg Med. 1984, 2(2):129-35.

    Stitt VJ. Stevens-Johnson syndrome: a review of the literature. J Natl Med Assoc. 1988 Jan, 80(1):104, 106-08.

    On Aug 05, 2004 at 6:58 pm Pat Edmonds wrote:

    . . . . .

    Seizure Med -- Zonegran

    On Sep 27, 2006 at 6:27 am Trisha Owens wrote:

    . . . . .

    I have been taking zonegran for 2 months now at a dose of 400 mg for epilepsy. I have noticed a definate decrease in weight. When I started the medication I weighed 194 lbs. and I am 5' 7". Two months later I have dropped down to 182 lbs. Thats 12 lbs in two months. So I am experiencing a very rapid weight loss with zonegran and am very happy with it.

    All my cravings are still there and I am still hungry as usual, but with a remarkable difference. I can only eat like maybe a fourth of whats in front of me. Sometimes I can eat more, but I get so full so quickly. Almost like I had my stomach stapled! I agree with not craving the carbonated soda. Now ice water tastes wonderful.
    If anyone has any more questions about my progress feel free to send me an email.

    On Dec 20, 2007 at 9:07 pm Rod R. wrote:

    . . . . .

    What about adding phentermine to the 300/400 bupropion/zonisamide combination? I have reached a plateau on the latter.

    On Dec 21, 2007 at 7:57 am Larry Hobbs wrote:

    . . . . .

    Rod,

    From what weight loss doctors have told me, phentermine is vastly superior to Wellbutrin ( bupropion ) for weight loss.

    At least one doctor has told me that as a weight loss drug, "Wellbutrin does not work."

    Most doctors who I am familiar with would probably give phentermine plus Zonegran ( zonisamide ) rather than Wellbutrin ( bupropion ) plus Zonegran plus phentermine, but your suggestion of adding phentermine is another possibility.

    On Dec 21, 2007 at 7:55 pm Rod R. wrote:

    . . . . .

    I neglected to mention that I originally started taking bupropion for seasonal affective disorder, and am continuing it as prophylaxis. The weight loss effect w/ zonisamide is a bonus. I asked about adding phentermine to the existing combo because I wish to continue taking bupropion. Any contraindications?

    On Dec 21, 2007 at 8:43 pm Larry Hobbs wrote:

    . . . . .

    Rod,

    I assume that there is a greater potential for stimulant side effects when combining two drugs like Wellbutrin and Phentermine, so I would be cautious and start with a low dose and be careful, that that said...

    Jerry Darm, MD uses the combination of phentermine plus Wellbutrin.

    An interview with Dr. Darm is posted here:

    http://fatnews.com/index.php?/weblog/comments/phen-wellbutrin-does-it-work-an-interview-with-dr-jerry-darm/

    --------

    One study found that weight loss was just as good with phentermine alone as with phentermine plus Wellbutrin.

    The story is posted here:

    http://fatnews.com/index.php?/weblog/comments/phentermine-wellbutrin-does-not-cause-more-weight-loss-than-phentermine-alo/

    --------

    I also wonder if phentermine is helpful with seasonal affective disorder. I have not heard of any doctors using it for this purpose, but I would think that it might work.

    On Jan 20, 2008 at 11:25 am Kate C. wrote:

    . . . . .

    Two things ... I've just started Wellbutrin again for seasonal affective disorder (which has been pretty well tolerated in the past), but never noticed much of a weight loss effect.

    I also just started Zonegran this week to reduce sweet/alcohol cravings. My beverage of choice is wine, and unfortunately it's increased to the point where I'm gaining weight. I had tried Topamax to curtail this before, and it actually worked, but it had a couple of undesirable side effects. Based on what I've read here about its similarity to Zonegran, I convinced my doc to prescribe the Zonegran.

    It's too early to tell if it's working, but I'm wondering about others' experiences. Has anyone taking Zonegran noticed a reduction in the desire for alcohol?

    Txs.

    On Jan 20, 2008 at 11:36 am Larry Hobbs wrote:

    . . . . .

    Kate,

    I would post your question in the Discussion Forum.

    People are more likely to see it there than here.

    I would post it as a new topic and maybe have the subject be something like "Does Zonegran reduce alcohol cravings?"

    On Jan 25, 2008 at 8:55 pm jackie wrote:

    . . . . .

    I just started taking zonisanide and have no side effect. My appetite is a little less for junk food which is great and I also eat proportionate sixed meals. I'm still waiting for the full dosage to see if it eliminates my nerve pain....If it does I have finally found me a winner!!!!

    On Jan 25, 2008 at 8:57 pm Larry Hobbs wrote:

    . . . . .

    Jackie,

    Very good.

    Keep us informed.

    I would follow what Dr. Piatek does exactly and increase the dose very, very slowly.

    He is the best of the best.

    On Feb 12, 2008 at 4:21 pm Winky1 wrote:

    . . . . .

    Kate C.,

    I recently joinged a research study for heavy drinkers which they are researching if zonisamide reduces cravings for alcohol but as a bonus also advised me to expect reduced appetite.

    I was recently taking meridia for weight loss for about 1 yr and lost around 50lbs but was finding myself indulging on the alcohol a little too much and saw this study so I am hoping to treat both problems with one drug- now thats if I am on the actual drug and not the placebo.... I have only been on it for 6days 100mg they will increase me 100mg every 2 weeks up to 600mg and then back down to 100mg - 12week study.

    I was told it takes a few weeks for it to get take effect if its the real thing but I already feel like I have a reduced appetite. So I don't know if what they are saying is true about time it takes effect. Does anyone out there know that answer?

    My goal is to be able to take control of my drinking which I only do as a social drinker mostly on weekends but I drink way too much at one time to the point I sometimes black out. Is anyone else out there taking this to lessen the craving for alcohol?

    On Feb 12, 2008 at 7:29 pm Larry Hobbs wrote:

    . . . . .

    Dr. Piatek has given Zonegran to thousands of patients over the past 4 years to help them lose weight.

    I emailed him and asked him if Zonegran reduces the desire for alcohol.

    He called and left a message ? I have not had a chance to talk to him yet ? and said that Topamax is better for reducing alcohol.

    A study just came out about Topamax reducing alcohol intake.

    Note that Winky1 said that she is going to have her dose increased from 100 mg to 600 mg ? wow --, then back down to 100 mg.

    Dr. Piatek said in his message that he is having very good results in his weight loss patients with 100 mg.

    I assume that the study Winky is in is a dosing study to determine what is the most effective dose ? if it is effective at all ? compared to the side effects that people experience at various doses.

    On Apr 27, 2008 at 3:23 pm robin wrote:

    . . . . .

    I've been on zonisamide for 4 weeks and I am finally getting my appetite back! I have lost ten pounds. I only weigh 104 and all I want to do is eat like normal again. We need to watch out about our pills I'll take them for seizures but not to lose weight. That's what we have the earth for...to run/walk on! Any info on how zonisamide works would be appreciated. Thank you.
    Also, what do you think of topamax, phenobarbital and zonisamide all together? Any ideas on some good combos with zonisamide?

    On Apr 27, 2008 at 5:10 pm Larry Hobbs wrote:

    . . . . .

    Robin,

    Zonegran reduces appetite by increasing the activity or serotonin and dopamine.

    Yes, I agree that people need to very careful about the drugs they take.

    I do not know if it is safe to take topamax, phenobarbital and zonisamide all together.

    I think it is always best to assume that drug combinations are not safe until you can find a doctor who has given this combination to hundreds of patients and can tell you that it is safe to do so.

    On Aug 01, 2008 at 4:41 am ram wrote:

    . . . . .

    Yes, I agree that people need to very careful about the drugs they take.

    A study just came out about Topamax reducing alcohol intake.

    On Aug 01, 2008 at 8:15 am robert skversky md wrote:

    . . . . .

    Since zonegran and topamax are very similar (Zonegran has fewer side effects but less weight loss in my experience),using them together is probably much like using two SSRI's at same time which doen't make sense to me.
    Not aware if together they have any synergistic effect in reference to seizure control. dr s

    On Aug 21, 2008 at 10:12 am JC wrote:

    . . . . .

    I have been taking 400mg zonegran and 150 wellbutrin since November. I lost 25 lbs. In May I stopped taking it because I noticed my hair was falling out...not in patches or anything... just in the bottom of the shower drain. In 3 months I gained back 14 lbs. My Dr. and I decided to put me back on it... I've lost 6 lbs already and feel great... except I'm already noticing the hair thing again. Do you know if this is something that will continue or stop after a few months???? I can't seem to find a lot on Zonegran and hair loss. Help!

    On Aug 21, 2008 at 10:50 am Larry Hobbs wrote:

    . . . . .

    JC,

    Good question.

    I don't know the answer, but I will ask Dr. Piatek if he has seen this in any of his patients and what he has done about it.

    Hair loss can occur with weight loss, so I don't know if it is specific to Zonegran or to the weight loss in general.

    Therefore, I will also ask other weight loss doctors and see what they say as well.

    It may take several days for me to hear from Dr. Piatek. He does not email regularly.

    -----

    Are you male or female?

    On Aug 21, 2008 at 11:03 am Larry Hobbs wrote:

    . . . . .

    JC,

    In an interview I did with Theodore VanItallie, MD, a guy who has been doing obesity research for 50+ years -- I don't even know if he is still alive -- said that a protein deficiency can cause hair loss along with other side effects.

    -------

    Here is the section of the interview where he talks about it.

    Hobbs: What are the side effects of protein depletion from too little protein?

    VanItallie: At the extreme, if consumed over a period of months, a very-low-calorie diet with a long-term protein content of less than 34 grams per day can cause heart arrhythmias and death.

    Several years ago at least 68 people died while on or shortly after being on a liquid protein diet for two to eight months. This was probably caused by a protein deficiency because the liquid collagen protein that they used was a poor quality protein.

    Less serious side effects include nausea, vomiting, diarrhea, constipation, fatigue, orthostatic dizziness, cold intolerance, dry skin, brittle nails, hair loss, muscle cramps, amenorrhea, decreased libido, euphoria, insomnia, anxiety, irritability, depression, and formation of gallstones.

    Protein depletion can also reduce strength, endurance and immunity.

    -------

    The interview is posted here:

    http://fatnews.com/index.php/weblog/comments/375/

    On Aug 21, 2008 at 11:11 am Larry Hobbs wrote:

    . . . . .

    JC,

    People who have had weight loss surgery sometimes have hair loss.

    One paper noted that zinc reversed hair loss in these patients.

    Caution: I would be careful about taking too much zinc. Doing so can create a copper deficiency and cause all kinds of problems.

    In the surgery patients, they gave HUGE doses of zinc -- 200 mg three times per day.

    I would NEVER, EVER, EVER suggest a normal, healthy person take this much.

    The only reason weight loss surgery patient need this much is because the surgery creates malabsorption, so they need to take a huge dose so that a little bit is absorbed.

    A dose of 15-30 mg per day is reasonable for a normal normal, healthy person.

    ----

    The article is posted here:

    http://fatnews.com/index.php/weblog/comments/799/

    On Aug 21, 2008 at 11:15 am Larry Hobbs wrote:

    . . . . .

    JC,

    Monte Meldman, MD, from Deerfield, Illinois, just emailed and said:

    ----

    "Hair loss occurs infrequently on phentermine and one can never tell if it is the drug, the weight loss or the natural history of hair loss that happens to everyone.

    "I have just plowed ahead and it stopped after a few long weeks...

    "It usually goes away by itself."

    -- Monte Meldman, MD

    On Aug 21, 2008 at 11:25 am JC wrote:

    . . . . .

    Thanks for the comments! I'm female to answer Larry Hobbs. My Dr. did suggest it might be from the weight loss which is why I did go back on the medication. I have suffered from binge eating/other eating disorders for 26 plus years and this is the first time I have been symptom-free. I hate to think that hair loss will be the reason I have to go off this miracle drug but I can't see myself bald either... I look forward to any other info you can find out about zonegran and this side effect. For the time being I will stay the course...

    Thanks!

    On Aug 21, 2008 at 11:26 am Larry Hobbs wrote:

    . . . . .

    JC,

    Studies also show that very-low calorie diets can cause weight loss.

    One study found that restricting a very-low calorie diet to two weeks had the advantage of less hair loss.

    On Aug 21, 2008 at 11:58 am Robert Skversky M.D. wrote:

    . . . . .

    I believe there are several reasons for hair loss/thinning in my patients. Rapid weight-loss may on occassion be responsible due to changes in estrogen/androgen balance. Since estrogen is stored in fat cells, estrogen levels could decrease with rapid fat loss with resultant "androgen alopecia". Phentermine/Adipex on rare occasions could be responsible as well as it being reported with both Topamax and Zonegran. I often have patients use Biotin (?value) and prescribe highest dose Rogaine which I believe is more helpful in preventing additional loss vs hair growth. In patients with PCOS the use of Spironolactone (anti androgen) is very helpful in eliminating facial hair as well as slowing hair thinning. Men could use propecia 1mg but proscar 5mg 1/2 3x/week is equally as effective and much cheaper. Avodart (off label) is better than either of the above.(Physician needs to be aware of PSA levels, prostate cancer studies, etc) dr s

    On Aug 21, 2008 at 11:59 am Larry Hobbs wrote:

    . . . . .

    JC,

    Dr. Anchors uses a combination of phentermine and an SSRI such as Prozac.

    On Aug 25, 2008 at 5:38 am Larry Hobbs wrote:

    . . . . .

    JC,

    Here is an email I received from Dr. Mark Eig.

    -------

    I have associated hair loss with patients whose percent skeletal muscle measurements decrease when they are losing weight.

    The relationship I look for is what I call "2-to-1 and opposite directions".

    This means that the percent body fat and the percent skeletal muscle change in opposite directions and that the measured fat percentage changes twice as much as the measured skeletal muscle.

    The patients who do not achieve this are less "healthy" in general and in most cases have less well defined exercise schedules, diet plan adherence, etc.

    -- Mark H. Eig, M.D.

    On Aug 26, 2008 at 12:02 pm Larry Hobbs wrote:

    . . . . .

    JC,

    Here is an email from Richard Rothman, MD, PhD regarding hair loss.

    Dr. Rothman is a smart guy who has coauthored 350 scientific papers.

    -------

    Dear Larry,

    I see a few patients per year who have hair loss associated with phentermine. The hair grows back when the phentermine is stopped and one can typically substitute phendimetrazine or diethypropion for phentermine.

    The mechanism of the hair loss is probably allergic. Thus, it is not surprising that other drugs could cause this problem. I did a quick google of "zonegran alopecia" and it is clear that alopecia (hair loss) is infrequently associated with zonegran. Similarly, wellbutrin is also infrequently associated with alopecia.

    The attached article mentions using zinc gluconate 50 mg daily for 2 weeks to encourage more hair growth. The obvious thing to do is to stop the medication that causes the hair loss.

    Regards,

    Richard Rothman

    On Aug 26, 2008 at 12:03 pm Larry Hobbs wrote:

    . . . . .

    Here is a second email from Richard Rothman, MD, PhD regarding hair loss.

    -------

    Dear Larry,

    I did forget to mention nutritional deficiency as a possibility. I've also seen that happen when patients do not eat enough and do not take a daily vitamin.

    Regards,

    Richard Rothman

    On Oct 31, 2008 at 2:39 am Femanol wrote:

    . . . . .

    I also have associated hair loss with patients whose percent skeletal muscle measurements decrease when they are losing weight.The relationship I look for is what I call "2-to-1 and opposite directions".This means that the percent body fat and the percent skeletal muscle change in opposite directions and that the measured fat percentage changes twice as much as the measured skeletal muscle.

    On Nov 06, 2008 at 12:24 am Sweeterex wrote:

    . . . . .

    Dear Larry,The attached article mentions using zinc gluconate 50 mg daily for 2 weeks to encourage more hair growth. The obvious thing to do is to stop the medication that causes the hair loss.

    On Nov 06, 2008 at 4:38 am Larry Hobbs wrote:

    . . . . .

    Sweeterex,

    I agree.

    On Jan 27, 2009 at 11:05 am Marie wrote:

    . . . . .

    Sweeterex,
    Sometimes it is better to just add the zinc to the other pills you are taking. The zinc won't hurt you if you stop taking your AED's it might and sometimes the effects last even after you stop taking the med's so it does not really matter or help.

    On Mar 08, 2009 at 4:03 pm Maddi wrote:

    . . . . .

    Has anyone had hairloss while taking Lamictal and low dose of Zonegran (25mg)? I tried taking Topamax, for just 6 days, and had alot of breakage that continued for 6 months after stopping the Topamax! I want to try Zonegran instead but am afraid I'll have the same reaction. Anyone???

    On Jun 20, 2009 at 1:34 pm Dr. Bob Allison wrote:

    . . . . .

    Dear Larry,

    I am so glad to hear that you stayed involved in weight loss. I spoke with you on several occassions in the past when I subscribed to your obesity newsletter and was really upset when this valuable resource was gone.

    Please let me know where I can read more on your involvement with weight loss.

    Sincerely,

    Dr. Bob

    On Sep 10, 2009 at 7:29 am Jada Loughlin wrote:

    . . . . .

    I personally do not think this is a safe enough drug to be taken for weight loss. However, with seizures you must decide which is the lesser of the two evils. I have taken Zonegran for over 2 years and it has MANY side effects!!! Which I've noticed seem to intensify as time passes. I'm not 100% sure of its effectiveness with the seizures, because my partials seizures come about as frequently and they did with Tegretol alone. (I now take 600 mg of Carbatrol 2 x per day and 300mg of Zonegran nightly) We had to switch the Zonegran to all at a bedtime dose because the headaches were so severe it would actually bring me to tears during the day. Which was odd for me because I never get headaches. I am currently talking to my doctor about weaning completely off because the side effect are getting so much worse and I am suffering from almost every single one, besides prickling or burning skin and the rash. (Listed below)

    Side effects may include:
    Abdominal pain, agitation, confusion, depression, diarrhea, difficulty concentrating, difficulty with memory, dizziness, double vision and other visual disturbances, drowsiness, fatigue, flu syndrome, headache, insomnia, irritability, loss of appetite, loss of muscle coordination, mental slowing, nausea, prickling or burning skin, rash, speech abnormalities, tiredness

    My IQ has had a marked change. It went from 146 to about 109! I've lost a huge amount of my vocabulary and the mental slowing is so traumatic for me. Then to lose the ability to speak properly is SUCH an embarrassing and strange side effect...always pausing at inappropriate times throughout sentences...slurring and the complete loss of the thought all together...it's really, really weird! The flu syndrome is really annoying...constantly sniffling and sudden rushes of fever. I also do not agree with the loss of craving for carbonated beverages or sweets those who are experiencing that are just having psychosomatic side effects. I drink Cherry Coke every day and I could drink a whole 12 pack of it everyday if it were in the house. I agree that weight loss IS a side effect, but that's only because of the nausea and abdominal pain and nothing really looks good to eat. However, once you do find a food that comforts the nausea (for me a double cheeseburger with just cheese from Mc Donald?s seems to do the trick) you do not get full any faster unless you haven't eaten in a few days and your stomach shrunk which is 100% a reaction to your body not eating and has nothing to do with the medication. I do agree that your alcohol consumption WILL go down. Although, I have a feeling it may have something to do with a learned response (kind of like Pavlov and his dog) because you will become intoxicated much more quickly and it causes you to vomit after only around 3 or so drinks (and who wants that!) This causes you to drink less often and then almost never. It does cause kidney stones too. I had a 7 mm kidney stone and had to have a Lipotripsy to remove it with no history of stones. I was able to pass the first three, but not that one. (They came all at once too by the way) This drug actually has A LOT of side effects, not a few and those side effects are detrimental to ones quality of life. I've taken almost every seizure medication available and this one really ranks up at the top of the list for side effects. I am getting off this because I am sick of walking around like a 31 year old Alzheimer?s patient. I find it to be insanity for Zonegran to be prescribed simply for weight loss.

    I do have a question though, why should you not take this if you have a sulfa allergy? What happens? I have a sulfa allergy.

    On Sep 10, 2009 at 10:22 am Larry Hobbs wrote:

    . . . . .

    Jada,

    Thank you very much for sharing your story and all the great information.

    Larry Hobbs

    On Sep 10, 2009 at 10:35 am Larry Hobbs wrote:

    . . . . .

    Jada,

    For whatever it is worth...

    John Mathews Larson, PhD notes that two amino acids may be helpful in preventing seizures.

    ALANINE:

    Converts quickly to usable glucose and prolongs blood sugar stability. (Helpful for hypoglycemics.)

    Reduces elevated triglycerides in diabetics; may be helpful in preventing seizures.

    Combined with high doses of B6, plays an important role in reversing immune deficiency by reproducing lymphocytes.

    ------

    TAURINE:

    Can help inhibit epileptic seizures;

    helps repair muscle and tendon damage; helps promote skin flexibility, stops alcohol withdrawal tremors.

    Is valuable in its potassium sparing ability, keeps the heart muscle adequately supplied with potassium.

    --------

    Larry Hobbs

    On Sep 10, 2009 at 10:37 am Larry Hobbs wrote:

    . . . . .

    Jada,

    In a book called "Food and Nutrients in Disease Management", Dr. Patricia Kane wrote a chapter about membrane-stabilizing nutrients called "Seizures".

    It's an expensive book (List Price $150), but you might call libraries in your area and see if they have it.

    http://www.amazon.com/Nutrients-Disease-Management-Ingrid-Kohlstadt/dp/1420067621

    Larry Hobbs

    On Sep 10, 2009 at 10:52 am robert skversky wrote:

    . . . . .

    Jada, Unfortunately you are having many of the untoward side effects most of which are dose related. Obviously you should at a minimum have your dosage decreased but even better discontinue based on your physician's recommendation. We have been using Zonegran and Topamax (much prefer the latter)for over 10 years in combination with other medications in several thousand patients for successful long term weight loss. As you may know several drug companies will in the very near future (?3-4 months)be coming out with similar combination meds approved for weight-loss. Your sulfa(sulfonamide) allergy (assuming its accurate and due to an antibiotic) will not cause an increase risk of allergic reaction to Zonegran. There is a difference between the sulfa based antibiotics vs sulfa based non antibiotics like Zonegran, dyazide, naprosyn etc. dr s

    On Sep 10, 2009 at 10:55 am Larry Hobbs wrote:

    . . . . .

    Jada,

    In a review of the book on Amazon, Kent Heckenlively wrote on July 29, 2009...

    ...

    The discussion begins with evidence of neuroinflammation discovered by Dr. Andrew Zimmerman and his colleagues at Johns Hopkins in 2005. This neuroinflammation upsets the balance between excitatory and calming neuro-transmitters, causing the glutamate system to become overexcited and GABA production to be curtailed. This results in the development of autistic symptoms and other neurological disturbances such as seizures.

    ...

    Children with seizures are more likely to have a buildup of very long chain fatty acids, but an exceptionally low amount of total lipid content within their cells, and thus HBOT treatment may increase their seizure activity. The high level of myelin marker DMAs (indicating brain inflammation), elevation of very long chain fatty acids (also from brain and liver inflammation) with low essential fatty acid levels from my daughter's test also explains the failure of her stem cell treatments last year. Her body didn't have enough short chain fatty acids to provide the raw materials necessary for the stem cells to flourish.

    In a similar vein, the ketogenic diet, which involves eating a great deal of fat, causes the body to burn off very long chain fatty acids forming lipid rafts or ceramides, but may not fully resolve the problem unless the essential fatty acids, phosphatidylcholine and butyrate are given. This may be why approximately one-third of the children who have success on the diet have their seizures reappear after stopping the diet. There is no need to use the severe restrictions of the ketogenic diet as Kane describes in another chapter of the book, "Food and Nutrients in Disease Management" on seizures. Kane has a diet called the Membrane Stabilizing Diet and can be found in the Detox Book for Patients.

    Hobbs: I assume what they mean was "The Patient's Detoxx Book" ($14.95).

    It can be purchased from BodyBio, which is Dr. Patricia Kane's company:

    http://www.bodybio.com/storecategory126.aspx

    ------

    This book appears to be about autism, but if it were me, I would call and ask the company if this book contains information that would be helpful for someone like you.

    Here is their contact information.

    BodyBio Inc
    Customer Service
    45 Reese Road
    Millville, NJ 08332 USA

    888.320.8338 Toll free Phone
    856.825.8338 Phone
    856.825.2143 Fax

    .(JavaScript must be enabled to view this email address)

    On Sep 10, 2009 at 10:57 am Larry Hobbs wrote:

    . . . . .

    Jada,

    In case it is not obvious from his comment...

    Robert Skversky is a doctor (MD).

    Larry Hobbs

    On Apr 26, 2012 at 5:00 am Katie H. wrote:

    . . . . .

    I have taken Phentermine in the past for weight loss and it works great! Amazing results but as soon as you go off of it watch out because your appetite comes back strong so in my experience I have gained back all of my weight plus each time I came off of it. Topomax was prescribed to me for headaches but I didn't know if could be used for weight loss. I didn't notice much of a chance. I have been on Wellbutrin for depression in the past along with Effexor and did notice a big difference there with appetite. I am now off Topomax because I was diagnosed with MS in December and the side effects were making my symptoms worse so now I'm on Zonegran as of yesterday so I'll try to notice if there is a difference in appetite as well. I sure hope so as I need the help since I'm often too tired to exercies anymore.

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