What is the mechanism of action (MOA) of topiramate in weight loss?

Topiramate is primarily an anticonvulsant medication that has also been found to have weight loss effects. Its mechanism of action related to weight loss involves enhancing gamma-aminobutyric acid (GABA) activity and modulating sodium channels. By enhancing GABA activity, topiramate can promote a calming effect on the nervous system, which may contribute to appetite suppression. Additionally, its action on sodium channels plays a role in its overall impact on neuronal excitability and neurotransmitter release, further contributing to its ability to suppress appetite and reduce food intake.

The combination of these effects leads to a decrease in hunger and a greater sense of satiety, which is critical for achieving weight loss in individuals taking this medication. This makes the enhancement of GABA activity and sodium channel modulation a key factor in topiramate's role as an adjunctive treatment for obesity, particularly in conjunction with behavioral changes and diet modifications.