Analysis of the Effectiveness and Safety of the Fentermine and Topiramate Association in Obesity: A Systematic Review of the Literature

Background: Obesity is a chronic disease characterized by excessive calorie consumption, leading to fat storage, and can manifest at any stage of life, with prevalence increasing progressively over the years, contributing to other health problems such as diabetes, cardiovascular diseases, and even certain types of cancer. The imminent global prevalence of obesity has emphasized the need for weight loss methods, including dietary adjustments, physical activity, and pharmacological therapy, which has significantly improved weight loss in individuals with obesity and overweight. Fentermina is a medication used to aid adolescents and adults with obesity who have not achieved sufficient weight loss through conventional methods such as diet and exercise. It acts as an appetite inhibitor by releasing dopamine and noradrenaline. Topiramate, a D-fructose derivative anticonvulsant, has a mechanism of action that is not yet fully understood, but it is known for its anticonvulsant action and participation in treating compulsive eating disorders, overweight, and obesity. Material and methods: A systematic review of the literature was conducted based on clinical trials and randomized controlled trials to collect publicly available information. The search was carried out thoroughly in four different search engines/databases: PubMed, Cochrane Library, Scopus, Google Scholar, and Web of Science. All identified publications were carefully examined and analyzed to ensure the quality and relevance of the collected information. Results: The literature review yielded a total of 21 references, of which 11 met the inclusion criteria. The research articles provided moderate evidence that the combination of Fentermina and Topiramato is effective and safe for obesity treatment. A gradual decrease in body weight was observed in patients from the beginning of treatment up to 20 weeks post-treatment. Additionally, notable secondary results were found, such as changes in blood pressure, triglyceride levels, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, and hemoglobin A1C levels from the beginning of treatment. Conclusion: The recommended doses for long-term weight control in adults are 3.75 mg, 7.5 mg, and 15 mg for Fentermina and 23 mg, 46 mg, and 92 mg for Topiramato. If a 5% weight loss is not achieved after 12 weeks with this dose, its use should be reconsidered.