Effects of tricyclic antidepressants, selective serotonin reuptake inhibitors, and selective serotonin-norepinephrine reuptake inhibitors on the ocular surface

Abstract

This study aimed to investigate the effects of tricyclic antidepressants, selective serotonin reuptake inhibitors, and selective serotonin noradrenaline reuptake inhibitors on the ocular surface. Methods: The study included 330 eyes of 165 patients using antidepressants and 202 eyes of 101 controls. Tear fluid breakup time, Schirmer I test, and Ocular Surface Disease Index (OSDI) questionnaire were administered. Beck Depression Inventory and Beck Anxiety Inventory were applied to record drug use, dosages, psychiatric disease duration, and remission time. Results: Mean tear fluid breakup time was 14.29 ± 4.81 (4-26) sec, and Schirmer I test value was 16.05 ± 5.89 (2-28) mm in study group. Tear fluid breakup time was 18.16 ± 2.12 (15-24) sec and Schirmer I test value was 16.64 ± 2.31 (15-24) mm in control group (p<0.001 and p=0.005, respectively). In study group, 38.18% (n=63) of patients had dry eye, and 17% (n=18) of patients in control group had dry eye (p<0.001). The mean OSDI score was 82.56 ± 16.21 (66-100) in the tricyclic antidepressants Group, 60.02 ± 29.18 (10-100) in the serotonin reuptake inhibitors Group, and 22.30 ± 20.87 (0-75) in the serotonin--noradrenaline reuptake inhibitors Group (p<0.001). Mean tear fluid breakup time was 14.36 ± 3.35 (10-20) sec in tricyclic antidepressants Group, 13.94 ± 5.81 (4-26) sec in the serotonin reuptake inhibitors Group, sec in serotonin-noradrenaline reuptake inhibitors Group (p=0.730). The mean Schirmer I test value was 9.90 ± 7.22 (2-30) mm in tricyclic antidepressants Group, 15.55 ± 5.15 (2-25) mm in serotonin reuptake inhibitors Group and 17.71 ± 4.21 (10-30) mm in serotonin-noradrenaline reuptake inhibitors Group (p<0.001). There was no statistically significant difference between OSDI score, tear fluid breakup time, and Schirmer I test values in serotonin reuptake inhibitors and serotonin-noradrenaline reuptake inhibitors subgroups. Conclusions: Dry eye is common in antidepressant users, but considering the ocular surface, serotonin-noradrenaline reuptake inhibitors may be more reliable than other antidepressants. Patients using serotonin-noradrenaline reuptake inhibitors have lower OSDI scores. Serotonin-noradrenaline reuptake inhibitors, which are useful in chronic pain syndromes, may also have a corrective effect on dry eye symptoms.

Prevalence of Dry Eye Symptoms and Associated Risk Factors among University Students in Poland

“…As was shown in a recent study, patients using SNRIs have lower OSDI scores than patients using SSRIs or TCAs. It suggests that among the most common antidepressants, SNRIs seem to have the least exacerbating impact on dry eye symptoms, which can be caused by their pain-reducing properties as they are also used in the treatment of chronic pain syndromes [57]. Other psychotropics were also shown to be associated with DED.…”

Antidepresan İlaçların Kornea ve Oküler Yüzey Üzerindeki Etkileri

“…In the sub-groups, reported that patients taking SSRI had worse findings than patients taking SNRI. 9 In another study, all dry eye tests and tear meniscus parameters were found to be significantly lower in the antidepressants group (Schirmer test, 11,4 ± 6,7 mm vs 22,5 ± 5 mm; TBUT, 5,3 ± 2,9 seconds vs 13,4 ± 1,7 seconds; tear meniscus height, 290,3 ± 133,6 μm vs 459,8 ± 180,3 μm, respectively). In addition, the OSDI score in the antidepressants group was significantly higher than in the control group (31,1 ± 21,2 ve 17,4 ± 11,8, respectively).…”