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Can I switch from Lyrica to Topamax for weight loss when suffering from depression?

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Addiction Medicine Specialist
Practicing since : 2002
Answered : 1486 Questions
I am currently on 150mg twice a day (Lyrica) for CRPS (only been on this 8 weeks having changed from Gabapentin) and 200 mg of Zoloft for depression. I have gained about 3kgs around the stomach already and I would like to know if I could change the lyrica for topamax and be able to lose weight and control pain? I live in Australia. XXXXXXX
Posted Wed, 12 Feb 2014 in Brain and Spine
Answered by Dr. Preeti Parakh 4 hours later
Brief Answer: Yes, you can. Detailed Answer: Hi XXXXXXX Welcome to Healthcare Magic! You can no doubt change Lyrica (Pregabalin) to Topamax (Topiramate) but I do not expect topiramate to give the same response in pain relief as Lyrica. I have some alternate suggestions for you. 1) Consider adding Topamax to your current regimen. This will mean you can continue deriving the benefit from both Lyrica and Topamax and you will need to use quite low doses of Topamax as the purpose is just weight loss and not pain relief. 2) The second option is to consider what can be done to Zoloft, which is the most likely cause of your weight gain. If it is possible to lower the dose of Zoloft and add something else, it may be better than having to change Lyrica which is not harming you at all. I assume that Zoloft also was prescribed for CRPS. If you wish, you can add bupropion to it as it also aids in weight loss. But please be aware that it may worsen myoclonic jerks which some people with CRPS have. It also should not be taken by people who have seizures. You should decide on the basis of what has helped you most, Lyrica or Zoloft. The one that has helped more should not be changed. I hope things work out for you. Please feel free to ask in case you need any clarifications. Best wishes. Dr Preeti Parakh MD Psychiatry
Above answer was peer-reviewed by
Follow-up: Can I switch from Lyrica to Topamax for weight loss when suffering from depression? 18 hours later
Can Topamax be prescribed by a General Practitioner or does it have to be prescribed through a Pain Clinic?. I live in Australia. P.S I take Zoloft for clinical depression and when I suffered a nerve injury to my foot, it was necessary for the Zoloft to be increased. XXXXXXX
Answered by Dr. Preeti Parakh 3 hours later
Brief Answer: Yes. Detailed Answer: Hi XXXXXXX Topamax can be prescribed by your GP as it is an anti-epileptic drug. It is not an opioid or a controlled substance. So no special licenses are required. Since you were prescribed Zoloft for depression, if you choose to take bupropion as well, it will have the added advantage of augmenting the anti-depressant action of Zoloft. Best wishes. Dr Preeti Parakh MD Psychiatry
Above answer was peer-reviewed by
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