A Prospective Observational Study on Changes in Intraocular Pressure and Iridocorneal Angle Following the Use of Escitalopram and Amitriptyline

Abstract

Background: Depression has emerged as one of the prime morbidities affecting professional and personal lives worldwide. Antidepressants are one of the mainstays of management of depressive episodes. Although antidepressants are considered a safe class of drugs, the studies examining the effects of antidepressant prescription on intraocular pressure (IOP) have shown a propensity to increase IOP, but not consistently. This study aimed to compare the changes in IOP and iridocorneal angle in drug-naïve patients with depressive episodes prescribed escitalopram or amitriptyline. Methods: Overall, 109 patients were recruited, of which 53 were prescribed amitriptyline and 56, escitalopram. A comparison of IOP and the iridocorneal angle at weeks 0, 4, and 8 was done using a two-way repeated-measures analysis of variance (two-way RM analysis of variance). Results: Patients initiated on escitalopram tended to show a higher rise in the IOP (left eye–[F = 3.27; P = 0.04]; right eye [F = 2.47; P = 0.08]). No difference was found in the iridocorneal angles in any of the four quadrants across both eyes. Conclusions: Escitalopram use had an association with an increase in IOP. While initiating patients on antidepressants, clinicians should be aware of this possibility, which can lead to ocular emergencies, and obtain a proper history of ocular morbidities.

Response to the comments on “A Prospective Observational Study on Changes in Intraocular Pressure and Iridocorneal Angle Following the Use of Escitalopram and Amitriptyline”

“…Pressure and Iridocorneal Angle Following the Use of Escitalopram and Amitriptyline" W e thank the reviewers who wrote the letter for taking an interest in our article. 1 We are grateful that they felt our study was pertinent to the context. We understand that their criticism is in the following aspects.…”

Comments on “A Prospective Observational Study on Changes in Intraocular Pressure and Iridocorneal Angle Following the Use of Escitalopram and Amitriptyline”

“…We read with interest the article by Mandal et al 1 It is a pertinent study on the effect of escitalopram and amitriptyline on intraocular pressure (IOP) and iridocorneal angle.…”