Research
Hormonal
Phentermine/Topiramate increases the risk of psychological side effects including depression, anxiety, sleep disorders, and irritability.
Avoid Phentermine/Topiramate if you have a history of psychiatric disorders, as it increases the risk of anxiety, sleep issues, and irritability. Other options like Tirzepatide or Semaglutide may be safer for mental health.
GoodRefutesHIGH confidence
Topiramate increased depression risk (RR 1.62... high certainty), and phentermine/topiramate raised concerns about anxiety (RR 1.91... high certainty), sleep disorders (RR 1.55... high certainty), and irritability (RR 3.31... high certainty).
Why this rating
High certainty evidence for psychological adverse events.
Source
Safety and effects of anti-obesity medications on weight loss, cardiometabolic, and psychological outcomes in people living with overweight or obesity: a systematic review and meta-analysis
Leiling Liu et al. · EClinicalMedicine · 2024
DOI 10.1016/j.eclinm.2024.103020
Meta-analysis · 154 studiesCited 45×
Read the paper DOI resolved against Crossref · corpus check 2026-06-10
More from this paper
- Tirzepatide produces the greatest weight loss and superior cardiometabolic improvements (blood pressure, triglycerides, glucose) among FDA/EMA-approved anti-obesity medications.Good
- Semaglutide and Liraglutide reduce the risk of Major Adverse Cardiovascular Events (MACEs), whereas Naltrexone/Bupropion increases the risk of elevated blood pressure.Good
Related findings · Hormonal
- Initial treatment for type 2 diabetes should be a combination of metformin and either an SGLT-2 inhibitor or a GLP-1 receptor agonist to achieve cardiorenal protection, rather than monotherapy or older agents like sulfonylureas.Strong
- For patients with specific monogenic obesity syndromes (leptin deficiency, POMC/PCSK1/LEPR mutations), targeted pharmacotherapy (recombinant leptin or setmelanotide) is highly effective and should be prioritized, unlike in polygenic obesity.Strong
- Continued weekly administration of 2.4 mg subcutaneous semaglutide prevents weight regain and promotes further weight loss in adults with overweight or obesity, whereas switching to placebo results in significant weight regain.Strong
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