Side Effects of Topamax, Wellbutrin May Increase Glaucoma Risk: Study

Users of Topamax or Wellbutrin may face an increased risk of experiencing vision problems such as glaucoma, according to the findings of a new study.

Researchers from the University of British Columbia report that the anti-seizure drug Topamax (topiramate), and the antidepressant Wellbutrin (bupropion) both are linked to an increased risk of angle-closure glaucoma in patients under 50.

The findings were published by the medical journal JAMA Ophthalmology on July 9, indicating that Wellbutrin appears to increase the risk two-fold, while Topamax increased the risk by a factor of five.

The study evaluated data from a large health claims database in the U.S. from January 1, 2006 to March 31, 2014, involving more than 6 million patients. Researchers found that patients younger than 50 were nearly twice as likely to develop angle-closure glaucoma if they took Wellbutrin, and more than five times as likely if they took Topamax.

Angle-closure glaucoma involves the rapid build-up of fluid and pressure in the eye. This can cause the iris to bunch up over drainage canals, resulting in headaches, eye pain, nausea, blurred vision, and rainbow-like halos over lights at night. It is typically corrected through conventional or laser surgery.

Both drugs are widely prescribed, the researchers noted, with Wellbutrin often prescribed as a smoking cessation aid in addition to use as an antidepressant.

The findings come as Johnson & Johnson’s Janssen subsidiary continues to deal with a number of Topamax birth defect lawsuits, which allege that inadequate warnings were provided about the risk of using the medication while pregnant.

While the drug maker has maintained that adequate Topamax warnings were provided about the potential pregnancy risks, the FDA required the drug maker to update the label information in March 2011, warning about a potential link between Topamax and oral cleft birth defects when the medication is used during the first trimester of pregnancy. The FDA has urged doctors to avoid giving Topamax to pregnant women or women who are of child-bearing age and at a high risk of pregnancy.

Oral cleft birth defects include cleft palate and cleft lip, which occur when parts of the lip or palate fail to completely fuse together. The defect results in the child being born with defects as small as a notched lip to extreme as an open groove that goes from the roof of the mouth to the nose. Cleft palate and cleft lip can cause problems eating and talking and can increase the risk of ear infections, resulting in the need for corrective surgery.

In April 2014, the drug maker reached an agreement to settle at least 76 complaints, although details of the Topamax settlement were not disclosed at that time.