Clinical Considerations Regarding the Use of Obesity Pharmacotherapy in Adolescents with Obesity.

Mechanism of action is possibly through modulation of various neurotransmitters, including the inhibition of voltage-dependent sodium channels, glutamate receptors and carbonic anhydrase and the potentiation of γ-aminobutyrate activity; off-label drug use for obesity treatment and also binge-eating disorder in adults) Efficacy: A small randomized, placebo-controlled pilot clinical trial evaluating topiramate in 30 adolescents ages 12–17 years with severe obesity (BMI ≥120% of the 95 th percentile or BMI ≥ 35 kg/m 2 ) showed a 2% BMI reduction on 75mg topiramate at 6 months which did not reach statistical significance compared to placebo following a short-term (1 month) meal replacement phase (−1.9%; 95% CI: −5.2% to +1.5%; P = 0.291).

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