Q:  Can Topomax Cause Bruising ...?

I have battled depression most of my adult life (I am 32), my question is about Topomax. Can Topomax cause bruising in the upper legs? I have had many bruises appear on my upper legs (thighs).  I don't think this is just from "spider veins". I take Wellbutrin and Effexor as well as the Topomax.


Dear Lisa -- 
Effexor could do that, as the serotonergic antidepressants (Effexor is part serotonergic/part noradrenergic, the latter meaning that it affects norepinephrine also) have been implicated in easy bleeding. Checking the "prescribing information", the stuff the company has to report to the FDA and then make public, on Topomax: "thrombocyctopenia" is on the list, which means the little fragments of blood cells called platelets, which form blood clots, are too few in number. That can be associated with easy bleeding; its related but not the same as the serotonergic antidepressant problem, so in theory the two together could be causing a problem where neither alone could. Out of curiosity, I looked to see if "thrombocytopenia" might be on the Wellbutrin list, and sure enough, so now all three are candidates for causing this. Obviously now we want to know which one of the three was started right before this problem developed, perhaps; that would be an obvious clue where to look (so it must not be that obvious, or you'd not have written? Could be a tricky search; good luck figuring that out.)

Dr. Phelps

Published Sept., 2006