Effects of selective serotonin reuptake inhibitors on intraocular pressure and anterior segment parameters in open angle eyes

Gündüz, Gamze Uçan; Yener, Neslihan Parmak; Kılınçel, Oğuzhan; Gündüz, Cem

doi:10.1080/15569527.2017.1330270

Cited by 17 publications

(14 citation statements)

References 24 publications

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“…These findings are similar to another cross-sectional study in which three groups of patients with open angle eyes were compared (patients receiving SSRI for 1 week to 6 months, longer than 6 months, or patients under no treatment). IOP was lower in patients under SSRI treatment for less 6 month or more than 6 months in comparison with controls, but the pupil diameter was higher in the abovementioned groups [30].…”

Section: Selective Serotonin Reuptake Inhibitors (Ssris) and Serotonin And Noradrenaline Reuptake Inhibitors (Snris)mentioning

confidence: 74%

“…5HT7 receptors are responsible for mydriasis through the relaxation of the sphincter muscle and for rising IOP by increasing the production of aqueous humour [28,29]. In addition, mydriatic effects might appear due to their weak anticholinergic and noradrenergic actions [30]. These contrary possible effects of stimulating serotonin receptors have determined researchers to study the possible real relationship between glaucoma and SSRIs and SNRIs in order to shed some light on the field (Table 1, Figure 1).…”

Section: Selective Serotonin Reuptake Inhibitors (Ssris) and Serotonin And Noradrenaline Reuptake Inhibitors (Snris)mentioning

confidence: 99%

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Psychopharmacological Treatment, Intraocular Pressure and the Risk of Glaucoma: A Review of Literature

Ciobanu

Dionisie

Neagu

et al. 2021

JCM

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Through the years, the available psychopharmacological treatments have expanded with numerous new drugs. Besides weight gain, gastro-intestinal problems or Parkinson-like symptoms, ocular adverse effects of psychiatric drugs have been reported. These adverse effects are not common, but can be dangerous for the patient. This review summarises the current knowledge on the risk of raised intraocular pressure and glaucoma entailed by psychopharmacological treatment. Also, it provides updated data for clinicians involved in the treatment of patients with glaucoma or glaucoma risk factors. For this purpose, we performed an extensive literature search in the PubMed database using specific terms. Selective serotonin and noradrenaline reuptake inhibitors are the best evidenced as having no association with glaucoma. Antipsychotics, and especially first generation, seem to have no correlation with an increased intraocular pressure and therefore possibly with a risk of glaucoma, although a special attention should be paid when using ziprasidone. Tricyclic antidepressants, benzodiazepines and topiramate should be avoided in patients diagnosed with glaucoma or at risk. Clinicians should be aware of the possible psychotropic drug induced glaucoma and monitor at risk patients closely in order to prevent this condition. Irrespective of the psychopharmacological regimen taken into consideration, the glaucoma patient should be under the strict supervision of the ophthalmologist.

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Section: Selective Serotonin Reuptake Inhibitors (Ssris) and Serotonin And Noradrenaline Reuptake Inhibitors (Snris)mentioning

confidence: 74%

Section: Selective Serotonin Reuptake Inhibitors (Ssris) and Serotonin And Noradrenaline Reuptake Inhibitors (Snris)mentioning

confidence: 99%

Psychopharmacological Treatment, Intraocular Pressure and the Risk of Glaucoma: A Review of Literature

Ciobanu

Dionisie

Neagu

et al. 2021

JCM

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“…The potential mechanism underlying this association is unclear but may be related to effects on serotonin receptors in the iris and ciliary body of the eye. The effect of serotonin on 5-HT7 receptors, which have been identified at the pupil sphincter, leads to relaxation of the sphincter muscle and can cause mydriasis [8,22,23]. Mydriasis could trigger a glaucomatous attack when it occurs in eyes that already have narrow iridocorneal angles.…”

Section: Discussionmentioning

confidence: 99%

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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“…Диаметр зрачка был значительно больше у пациентов обеих подгрупп, получавших СИОЗС, чем в контрольной группе (3,53±0,71 мм и 3,48±0,60 мм против 3,11±0,72 мм, p<0,05), однако зависимость от продолжительности лечения не найдена. Механизмами развития мидриаза при приеме СИОЗС являются легкий М-холиноблокирующий эффект этих препаратов, а также стимуляция рецепторов 5-НТ 7 , 5-НТ 2А и 5-НТ 2С , расположенных в сфинктере радужки [28]. Расширение зрачка само по себе не вызывает зрительного дискомфорта и проходит самостоятельно после прекращения терапии [4].…”

Section: селективные ингибиторы обратного захвата серотонинаunclassified

“…Так, у лиц монголоидной расы риск развития острого приступа ЗУГ при приеме СИОЗС увеличивается в 5,8 раза [29]. Интересно, что у лиц с открытым углом передней камеры глаза прием СИОЗС приводит к снижению уровня ВГД [30].…”

Section: селективные ингибиторы обратного захвата серотонинаunclassified

Side effects of psychotropic drugs on eye

Petukhova¹,

Panov²,

Malygin³

et al. 2021

Russian Journal of Clinical Ophthalmology

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Any antipsychotics provoke more or less ocular complications. Some of them are relatively harmless (i.e., dark eyelids, conjunctival and corneal pigmentation, mydriasis, nystagmus, dry eye etc.). These adverse effects are resolved spontaneously after treatment discontinuation, drug switching, or prescribing additional therapy. However, the intake of both typical and atypical neuroleptics, lithium salts, some anticonvulsants (e.g., topiramate) is associated with high risks of vision loss. Moreover, in some patients these medications may result in blindness. The use of psychotropic drugs (e.g., tricyclic antidepressants or serotonin reuptake inhibitors) in patients with higher risk of acute angle closure is of particular concern. The association between phenothiazines and anticonvulsants and retinopathy, chlorpromazine and cataract, anticonvulsants and poor color vision and reduced contrast sensitivity is also important. Psychiatrists and ophthalmologists should consider potential ocular side effects in patients receiving psychotropic drugs. Knowing management algorithm for these conditions is also important. The number of recent publications on this issue is limited. Therefore, articles older than 10 years are sometimes used. Keywords: eye, visual organ, adverse effects, psychotropic drugs, neuroleptics, tricyclic antidepressants, selective serotonin reuptake inhibitors, glaucoma, retinopathy, cataract. For citation: Petukhova A.A., Panov A.A., Malygin Ya.V., Kazanfarova M.A. Side effects of psychotropic drugs on eye. Russian Journal of Clinical Ophthalmology. 2021;21(1):29–33. DOI: 10.32364/2311-7729-2021-21-1-29-33.

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Effects of selective serotonin reuptake inhibitors on intraocular pressure and anterior segment parameters in open angle eyes

Abstract: Selective serotonin reuptake inhibitors cause mydriasis which is persistent during the treatment. In depression patients with open angle eyes, short- and long-term use of SSRIs leads to decrease in IOP.

Cited by 17 publications

References 24 publications

Psychopharmacological Treatment, Intraocular Pressure and the Risk of Glaucoma: A Review of Literature

Psychopharmacological Treatment, Intraocular Pressure and the Risk of Glaucoma: A Review of Literature

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

Side effects of psychotropic drugs on eye

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