title: Combination phentermine and topiramate for weight maintenance: the first Australian experience.
abstract: OBJECTIVE
  To investigate the safety, tolerability and efficacy of combination phentermine and topiramate therapy for maintenance of weight loss.
  
  
  METHODS
  Retrospective audit of patients attending the Austin Health Weight Control Clinic who were dispensed phentermine-topiramate between 22 January 2010 and 16 July 2012 and after reaching a target weight by following a very low energy diet (VLED). Data collection continued until July 2013.
  
  
  METHODS
  Number of patients who ceased pharmacotherapy; duration of use of pharmacotherapy; types and numbers of adverse effects; and mean weight and blood pressure measurements at the initial visit, the end of the VLED and the last observation during pharmacotherapy.
  
  
  RESULTS
  Data were available for 103 patients who were dispensed phentermine-topiramate; 61 patients ceased combination pharmacotherapy before the end of the data collection period, 41 due to adverse effects (eg, paraesthesia, cognitive changes, dry mouth and depression). The mean duration of use of pharmacotherapy was 10 months. Mean weight decreased by 10% due to the VLED (from 135.5 kg to 122.5 kg) and this loss was maintained. For 30 patients who continued on phentermine-topiramate, the mean duration of pharmacotherapy was 22 months and the mean weight decreased by 6.7 kg between the end of the VLED and the last observation during pharmacotherapy.
  
  
  CONCLUSIONS
  Phentermine-topiramate therapy was not well tolerated; more than half of the patients in our study stopped taking it because of adverse effects, and more than half of the adverse events reported were ascribed to topiramate. However, in those able to continue with pharmacotherapy, the combination was efficacious for both maintenance of weight loss and ongoing weight loss.
authors.affiliation: Department of Endocrinology, Austin Health, Melbourne, VIC, Australia. j.proietto@unimelb.edu.au.
authors.forename: Sandra L
authors.initials: SL
authors.lastname: Neoh
authors.affiliation: Department of Endocrinology, Austin Health, Melbourne, VIC, Australia.
authors.forename: Priya
authors.initials: P
authors.lastname: Sumithran
authors.affiliation: Department of Endocrinology, Austin Health, Melbourne, VIC, Australia.
authors.forename: Cilla J
authors.initials: CJ
authors.lastname: Haywood
authors.affiliation: Department of Endocrinology, Austin Health, Melbourne, VIC, Australia.
authors.forename: Christine A
authors.initials: CA
authors.lastname: Houlihan
authors.affiliation: Department of Endocrinology, Austin Health, Melbourne, VIC, Australia.
authors.forename: Fiona T H
authors.initials: FT
authors.lastname: Lee
authors.affiliation: Department of Endocrinology, Austin Health, Melbourne, VIC, Australia.
authors.forename: Joseph
authors.initials: J
authors.lastname: Proietto
mesh_terms: D019440:Anti-Obesity Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001315:Australia / Q000453:epidemiology; D015992:Body Mass Index; D004359:Drug Therapy, Combination; D005500:Follow-Up Studies; D005632:Fructose / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D006801:Humans; D008485:Medical Audit; D009765:Obesity / Q000188:drug therapy* / Q000453:epidemiology; D010645:Phentermine / Q000008:administration & dosage* / Q000009:adverse effects; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D000077236:Topiramate; D017211:Treatment Failure; D016896:Treatment Outcome; D015431:Weight Loss / Q000187:drug effects
chemical_list: D019440:Anti-Obesity Agents; D000077236:Topiramate; D005632:Fructose; D010645:Phentermine