The Dangers of Weight Loss Drugs Belviq and Qsymia

The Dangers of Weight Loss Drugs Belviq and Qsymia Bipolar Disorder Treatment Medications Print The Dangers of Weight Loss Drugs Belviq and Qsymia Proceed with caution especially if you have bipolar disorder By Marcia Purse Marcia Purse is a mental health writer and bipolar disorder advocate who brings strong research skills and personal experiences to her writing. Learn about our editorial policy Marcia Purse Medically reviewed by Medically reviewed by Steven Gans, MD on August 05, 2016 Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Steven Gans, MD Updated on January 21, 2020 Jose Luis Pelaez Inc / Getty Images More in Bipolar Disorder Treatment Medications Symptoms Diagnosis In This Article Table of Contents Expand Diet Pill Cautions How Belviq Works Cautions When Taking Belviq Side Effects of Belviq How Qsymia Works Cautions When Taking Qsymia Other Warnings About Qsymia Side Effects of Qsymia View All Back To Top In June and July of 2012, the Food and Drug Administration (FDA) approved two new weight loss drugs, Belviq (lorcaserin)  and Qsymia (phentermine/topiramate).?? For people who have gained weight on psychiatric drugs, these drugs may seem appealing, but in reality, there are some important cautions. Cautions With Belviq and Qysmia Each of these two anti-obesity drugs can have negative effects on people with mood and sleep disorders, and there are some potentially problematic interactions with psychiatric drugs. If you are taking psychiatric medications like selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs), Wellbutrin (bupropion), monoamine oxidase inhibitors (MAOIs), lithium or antipsychotics,  its extremely important that you work closely and collaboratively with the physicians who prescribe both your psychiatric and weight loss medications. How Belviq Works This medication acts on serotonin, a neurotransmitter that has been implicated in depression.?? Because many psychiatric meds also work on the serotonin system, its not surprising that theres a potential for serious side effects when these medicines are combined. Cautions When Taking Belviq Serotonin syndrome and neuroleptic  malignant syndrome, both potentially life-threatening conditions, are possible with drugs that affect serotonin, so adding Belviq to existing medications might make developing either of these conditions more likely. The risk and safety of Belviq when used with other drugs that affect serotonin hasnt been evaluated yet, but the label contains a warning to use extreme caution when administering Belviq with SSRIs, SNRIs, TCAs, Wellbutrin, MAOIs, antipsychotics, lithium and St. Johns wort.?? Side Effects of Belviq Potential side effects of Belviq include:?? DizzinessTirednessHeadacheDry mouthConstipationNausea How Qsymia Works Qsymia is a combination of two drugs, phentermine, and Topamax (topiramate). Topamax is an anti-epilepsy drug sometimes used as a mood stabilizer in bipolar disorder. Phentermine has been used since 1959 in the U.S. for short-term obesity treatment and Topamax has been FDA approved for seizure disorders and migraine prevention.?? Because patients who were taking Topamax for those conditions were losing weight, research was conducted on how effective it was in treating obesity. The combination of the two drugs evidently work better together than alone, and thats how Qsymia was born. Cautions When Taking Qsymia For the last few years, the FDA has required all anticonvulsant medications to carry a warning about a potential increase in suicidal ideation.?? Since Qsymia contains topiramate, which is an anticonvulsant, the official prescribing information for the drug contains a warning that Qsymia may cause mood disorders. Qsymia is especially risky for people who have a history of depression because it can cause the depression to come back or other mood disorders to develop. It also says that if symptoms dont go away or are troublesome, Qsymia should be decreased or stopped. If you have suicidal ideation or behavior, Qsymia needs to be stopped immediately. It also should not be taken if you have a history of suicidal ideation or attempts.?? Other Warnings About Qysmia Other additional issues can include:?? Problems when Qsymia is taken along with benzodiazepines, a type of anti-anxiety and sedative medication, or other sleep medications.Qsymia should not be taken during or within 14 days of stopping any MAOI antidepressant.Care is needed when taking this drug with an anticonvulsant mood stabilizer, especially carbamazepine  and valproate. Side Effects of Qsymia Potential side effects of Qsymia include??: DizzinessDry mouthTrouble sleepingTaste and smell changesTingling The Bottom Line Its not impossible for people who have bipolar disorder or major depression to be treated with either of these drugs, but extremely careful monitoring is necessary. Life-threatening side effects are possible. In some cases, regular blood tests are recommended. Work with your doctors closely if either Belviq or Qsymia is prescribed for you. Tell them about any changes in mood, sleep, anxiety, stress, or physical health. Losing weight is not worth the significant health problems that could occur when taking these drugs.