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Topamax or Metformin, which is better for weight loss?

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I didn't know where to put this post. Feel free to move it if it belongs else where. So basically, my pdoc has given me the choice of trying topamax or metformin for weight loss. I did some research and they both seem to have about the same efficacy rate. I am titling slightly toward topamax because it might have some effect on my mood as well. However, I am terrified of some of its side effects. I don't want to turn in an idiot that can't remember anything. But then again I won't know until I try it. Any thoughts? Thank in advance.  

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Oh boy. Where do I start. I take both together. 2,000 mg metformin and 200 mg topamax. I see a weight management dr at an adult weight loss clinic.

Metformin gave me some tummy issues that were easily remedied by adding some extra fiber to my diet (a bowl of Raisin Bran cereal almost  daily). Otherwise yeah. Bathroom issues were pretty constant. But I find it helpful.

As for topamax, I have a shit memory and I do have some VERY minor word finding issues that no one notices (I speak as any 36 year old speaks I’ve found). But I’m on a lot of meds. And I’ve never had the greatest memory. And I don’t exercise my brain. I don’t work so I don’t problem solve. I don’t have any social interactions besides 2 times a week family dinners. I see my husband 2 days a week. So my life is dull. I would really readily blame that. I manage by having a rather large planner and making notes of things I want to do or need to do for the day. But many people use planners, even young students. So I can’t say I can blame topamax for anything. And I find it helpful too.

I have lost at least 60 lbs since 2014 which I attribute to getting off of seroquel and also starting both metformin and topamax. I also (before the pandemic virus) had been exercising 2-4 times a week for 30 mins. Just speed walking on the treadmill.

Unfortunately, I started both topamax and metformin at the exact same time. So I can’t tell you which one worked best for me personally. I suppose you could ask to try the topamax and see if you have side effects and if not see if it helps with weight and mood too. And then possibly even add metformin in addition to the topamax if your pdoc deems it appropriate. I hope this helps with my sharing my experience. Good luck with your decision! Keep us posted!

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The cognitive effects of Topamax are REAL. But they are dose dependent. I'm currently on Trokendi XR (a version of Topamax) 50 mg and experience minimal cognitive side effects, but have been on the max of 400 mg and couldn't put together sentences. It can also cause kidney stones. But it can improve glucose levels as well as insulin resistance if I recall correctly.

Metformin is very hard on your stomach (extended release is easier though) and depletes vitamin B12 (can be mitigated with supplementation), but is very good for restoring insulin sensitivity (better than Topamax) which would be good as you are on clozapine, and has anti-aging properties supposedly.

I lost weight with neither, but that's my experience.

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