Antidepressants use and risk of cataract development: a systematic review and meta-analysis

Fu, Yana; Dai, Qi; Zhu, Liwei; Wu, Shuang‐Qing

doi:10.1186/s12886-018-0699-0

Cited by 17 publications

(18 citation statements)

References 23 publications

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“…In this study, a significant, direct association with cataract indigence was seen with Fluoxetine and Fluvoxamine administration. Other SSRIs were not associated with the risk of cataract development [7]. It illustrates that, although the mechanisms of all SSRIs are similar, some of them may predominantly affect the eye lens.…”

Section: Discussionmentioning

confidence: 87%

“…To understand the mechanism for the risk of cataract development with SSRIs, the pharmacodynamics of SSRIs must first be examined. Animal models have clearly proven that there is a large number of serotonin receptors in the eye lens, which play a significant role in maintaining lens transparency [7]. Increased serotonin levels in the lens milieu have been shown to induce lens opacity in these animal models, which predicts cataract development.…”

Section: Discussionmentioning

confidence: 99%

“…The increasing use of SSRIs has necessitated new studies assessing their safety and adverse effects. However, the systemic side effects of this neurotransmitterincluding weight gain, anxiety, insomnia, increased appetite, vertigo, nausea, sexual problems and itching are not well researched in humans [6], though some preliminary studies have been performed in animal models [7].…”

Section: Introductionmentioning

confidence: 99%

“…SSRIs work by increasing serotonin levels in the brain, and serotonin receptors have been identified in the lens, aqueous humour and iris of the human eye [8,9]. In animal models, serotonin has been shown to play a critical role in lens transparency, and, thus, it is postulated that increased levels of serotonin may be associated with lens opacity in human eyes, as well [7]. Recently, several studies have indicated that serotonin may play a causal role in cataract development [10,11].…”

Section: Introductionmentioning

confidence: 99%

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Early effects of selective serotonin reuptake inhibitors (SSRIs) on cornea and lens density in patients with depression

Karaküçük

Beyoğlu

Çömez

et al. 2019

Psychiatry and Clinical Psychopharmacology

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PURPOSE: To investigate the effects of SSRIs on cornea and lens density, intraocular pressure (IOP) and anterior chamber parameters, including anterior chamber volume (ACV), anterior chamber depth (ACD), corneal volume (CV) and central corneal thickness (CCT), in patients with depression during a three-month follow-up period. METHOD: In this prospective study, 31 total patients, who were prescribed SSRIs for depression, were recruited. Sertraline, 50 mg/daily, was given to ten patients; 11 received Escitalopram, 10 mg/daily; and ten were treated with Fluoxetine, 20 mg/daily. The parameters recorded were corneal density (CD), lens density (LD), IOP, ACV, ACD, CV and CCT at the start of treatment, as well as at one-week, one-month, and three-month follow-ups. RESULTS: The study revealed that there was no risk of cataract development from three months of SSRI intake. Significant decrease in ACD was recorded at the one-week follow up; however, after three months, this decrease was insignificant compared to the baseline. ACV, CV, CCT, CD and LD showed no significant alterations in any of the follow up examinations over the threemonth period. IOP, however, significantly fell (a P value of 0.004). CONCLUSION: In this study, SSRI use does not seem to be associated with an increased risk of cataract or glaucoma or with changes in CD and LD. Long-term follow-up is necessary to determine the actual risk of cataract or glaucoma with SSRI intake.

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Early effects of selective serotonin reuptake inhibitors (SSRIs) on cornea and lens density in patients with depression

Karaküçük

Beyoğlu

Çömez

et al. 2019

Psychiatry and Clinical Psychopharmacology

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“…The meta-analysis 3 and its findings were characterized by many limitations. The source of the heterogeneity was not identified, and so biasing influences remain unknown.…”

Section: E2mentioning

confidence: 99%

Antidepressants, Mood Stabilizers, Antipsychotics, and the Risk of Cataract

Andrade

2019

J. Clin. Psychiatry

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Depression and Eye Diseases Zheng et al 1 described a systematic review and meta-analysis of depression and depressive symptoms in patients with eye diseases. They identified 28 relevant studies (pooled N = 6,589) and estimated that the prevalence of depression or depressive symptoms was 25% (95% CI, 20%-30%) in the pooled sample. The highest prevalence was found in patients with xerophthalmia (29%). The prevalence was also high in patients with glaucoma (25%), age-related macular degeneration (24%), and cataract (23%). Patients with eye disease were at higher risk of depression or depressive symptoms than healthy controls (odds ratio [OR], 1.59; 95% confidence interval [CI], 1.40-1.81). It is possible that the depression in patients with eye disease is a reaction to the ocular symptoms, and it is possible that the depression and eye disease occur coincidentally. It is also possible that depression and its correlates are a risk factor for at least some eye diseases. In this context, one possibility is that the antidepressant drugs used to treat depression increase the risk of cataract. Cataract Cataract is a disease of the eye that is characterized by impairment of vision resulting from the development of opacities in the lens. Cataract is the leading cause of blindness in low and middle income countries. The prevalence of cataract is about 4% in persons who are around 60 years of age and > 90% in those who are 80 years and older. Risk factors for cataract include older age, female sex, genetic vulnerabilities, lifestyle behaviors, medical comorbidities, and many others. 2 Psychotropic drugs, particularly antidepressant drugs, have recently been associated with cataract. This article critically examines the literature on the subject. Antidepressant Drugs and Cataract: Meta-Analysis Fu et al 3 described a systematic review and meta-analysis of studies that examined the development of cataract after antidepressant use. They searched electronic databases, reference lists, and other sources and identified 7 relevant case-control studies; 3 had been conducted in the United States, 2 in Canada, and 1 each in the United Kingdom and Taiwan. The pooled sample included 447,672 cases and 1,510,391 controls. Important findings from the meta-analysis 3 are presented in Table 1. In short, selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, and tricyclic antidepressants were each associated with a small but statistically significant increase in the risk of cataract. All 3 analyses were characterized by substantial heterogeneity; the authors did not examine the source of the heterogeneity. Among individual antidepressant drugs, the risk was significant for citalopram, fluoxetine, fluvoxamine, and venlafaxine but not for paroxetine, sertraline, escitalopram, duloxetine, and milnacipran; it is possible that many analyses were underpowered for the individual drugs. Visual inspection of the funnel plot suggested clear publication bias.

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