Patient/caregiver was educated on precautions to be exercised while taking Topamax as follows:

  1. Topamax use can result in obstruction to the drainage of fluid (aqueous humor) in the eye, increase in the intraocular pressure, and leading to glaucoma. Individuals can present with eye pain, headache, and diminished vision with haloes around light, which can progress to vision loss and permanent blindness, if not acted upon immediately. Observe compliance with any periodical vision exams recommended. Report to your physician immediately regarding any findings such as, eye pain, any changes with vision, such as blurred vision or double vision, so that, your plan of care could be revised accordingly.
  2. Topamax use, especially in individuals with history of mood disorders, can result in worsening of anxiety and depressive symptoms, changes in behavior, trouble sleeping, gross appetite changes, impulsiveness, agitation, irritability, and suicidal thoughts. Closely watching for the therapeutic response and developing side-effects, with timely reporting the findings to the physician, can allow appropriate changes in the dose of Topamax and plan of care. This can help with better management of your condition and avoid risk for worsening of behavioral and mood disorders.