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Common adverse effects reported in clinical trials include: Paraesthesia (tingling sensations in extremities) occurring in 2025% of participants, attributed to topiramate's carbonic anhydrase inhibition [4] [5] Dry mouth affecting approximately 20% of users, related to phentermine's sympathomimetic effects Constipation reported in 1517% of participants Dysgeusia (altered taste perception) particularly metallic taste, affecting 1015% Insomnia occurring in 1012%, linked to phentermine's stimulant properties Dizziness and cognitive effects including difficulty with concentration, memory, and word-finding Serious safety concerns require particular attention

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