Dr Lipman Shows You the Side Effects of Qsymia

What are The Possible Side Effects of Qsymia?

Common Side Effects Include: 

*Numbness or tingling in the hands, arms, feet, or face (Paraesthesia) 
*Change in the way foods taste or loss of taste (dysgeusia)
*Dry mouth
*Mood changes, Trouble Thinking, Concentration, and Insomnia

Less Common Side Effects Include:

*Qsymia may cause depression or mood problems, and trouble sleeping. Tell your healthcare provider if symptoms occur.
*Concentration, memory, and speech difficulties. Qsymia may affect how you think and cause confusion, problems with  concentration,   attention, memory or speech. 
*Increases of acid in bloodstream (metabolic acidosis). If left untreated, metabolic acidosis can cause brittle or soft bones (osteoporosis, osteomalacia, osteopenia)
*Kidney stones
*Can slow the rate of growth in children, and may possibly harm your baby if you are pregnant. 

*Not feel hungry (loss of appetite)-- a side effect and an effect 
*Feel changes in heartbeat--rapid heart beat, a mild effect and common, little to no blood pressure effect 
*Decreased sweating and increased body temperature (fever). People should be watched for signs of decreased sweating and fever, especially in hot temperatures. Some people may need to be hospitalized for this condition.

​Adverse Effects Leading to Stopping Treatment:

​Here are the adverse effects that led subjects to stopping the treatment. Not the worse effect was blurred vision
that occurred in 2.1% of subjects and was not related to dose of the drug. Headaches, irritability, paraesthesias
and insomnia occurred in less than 2% of cases. 

doses ofa qsymia
Most of the side effects seen above are dose related. i.e. the more you take the more the side effects. Look at the "insomnia" and "anxiety" line where the side effects are  4-5 times more with
the 15/92 dose.  Look how few side effect with the 3.75/23 dose, some even less than placebo.

This clearly re-enforces the old rule about medications, "always take the lowest, effective dose."
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The Side Effects

The side effects of Qsymia are not predictable by looking at the side effects of the components -phentermine and Topamax for two reasons.

1. The first reason is that the doses of each of the ingredients are much, much lower than used typically when the drugs are used alone.
Even the top dose of phentermine is only 15 mg which is less than 1/2 of the typical dose of 37.5 mg used in adipex- the most common
form of phentermine. Even children treated with topamax take up to 300 to 400 mg of topamax a day. Note the top dose of topamax in Qsymia is only 92 mg. 

2.The other reason you cannot use the side effects of the individual drugs to predict the side effects of the combination is that the 
side effects of each of the two components have a tendency to  cancel one another out. The drowsiness of topmax cancels the insomnia of phentermine. The irritability of phentermine is lessened by the sedation of the topamax. There are many other examples of this. The only way to evaluate the side effects of Qsymia is to look at the drug as a whole. Below are the side effects of Qsymia reported by the
drug company.

Most of the side effects were less than 1.7%. However, in some people than can be distressing. Read more
I have treated over 300 patients with Qsymia in the past year. My experience differs from the literature  reported above. Unfortunately, I found a much high incidence of side effects in my patients. Nearly 20% of patients report side effects, usually sleepiness and lack of concentration due to the topamax. Other side effects I noted was numbness in the finger tips and some taste disturbances for diet sodas. I found a few patients the Topmax caused depression.  

In all, the drug is well tolerated. About 10-15% of patients had to stop the drug because of side effects. About 5-10% noted side effect that were 
tolerable. Most of these patients noted the side effect became less as they took the medication. 

​Another 10% felt the weight loss results was not worth the cost of the medication. 

Side Effects Observed by Dr Lipman in Patients He Has Treated With Qsymia

by Richard Lipman 
7241sw 63 ave
Miami, Fl 33143 USA
305 670-4369
25° 42.190326', -80° 17.746236'