Ocular Adverse Effects of Antidepressants – Need for an Ophthalmic Screening and Follow up Protocol

Main Article Content

Varsha Narayanan

Abstract

Depression is emerging to be one of the commonest mental health disorders worldwide affecting a wide age group. The prescription of antidepressants has risen considerably in last decade with a preference for using newer antidepressants like Selective Serotonin Reuptake Inhibitors (SSRIs). There have been many published reports of Ocular side effects with Antidepressants related to Dry eye, Visual disturbance, Angle closure glaucoma and Retinal effects. There has also been a significant rise in antidepressant usage by the elderly, which is a population at risk for ocular adverse effects. Therefore, it is pertinent to understand the antidepressants from the perspective of their mechanisms of action and all possible Ocular adverse effects, and develop an Ophthalmic screening protocol and follow up for patients being put on Antidepressants. Patients should also be counselled for reporting alert signs of ocular side effects immediately. These steps may help to avert and decrease visual complications with Antidepressants.

Keywords:
Selective Serotonin Reuptake Inhibitor (SSRI), Tricyclic Antidepressant (TCA), angle closure glaucoma, ocular adverse effect, depression

Article Details

How to Cite
Narayanan, V. (2019). Ocular Adverse Effects of Antidepressants – Need for an Ophthalmic Screening and Follow up Protocol. Ophthalmology Research: An International Journal, 10(3), 1-6. https://doi.org/10.9734/or/2019/v10i330107
Section
Review Article

References

WHO India and Global Depression statistics updated; 2019.

Available:http://www.searo.who.int/india/topics/depression/about_depression/en/

Rathod MS, Dixit JV, Goel AD, Yadav V. Prevalence of depression in an urban geriatric population in Marathwada region of Western India. Indian J Psychol Med. 2019;41:32-7.

Hasler G. Pathophysiology of depression: do we have any solid evidence of interest to clinicians? World Psychiatry. 2010; 9:155-161.

Winerman L. By the numbers: Antidepressant use on the rise. American Psychological Association. 2017;48(10): 120. Available:https://www.apa.org/monitor/2017/11/numbers

Tripathi A, Avasthi A, Desousa A, Bhagabati D, Shah N, Kallivayalil RA, et al. Prescription pattern of antidepressants in five tertiary care psychiatric centers of India. Indian J Med Res. 2016;143(4): 507–513.

Zhong H, Haddjeri N, Sánchez C. Escitalopram, an antidepressant with an allosteric effect at the serotonin transporter--a review of current understanding of its mechanism of action. Psychopharmacology (Berl). 2012;219(1): 1-13.

Taylor C, Fricker AD, Devi LA, Gomes I. Mechanisms of action of antidepressants: from neurotransmitter systems to signaling pathways. Cell Signal. 2005;17(5):549–557.

Richa S, Yazbek JC. Ocular adverse effects of common psychotropic agents: A review. CNS Drugs. 2010;24(6): 501-26.

Kirkham J, Seitz D. Evidence of ocular side effects of SSRIs and new warnings. Evid Based Ment Health. 2017;20(1):27.

Graylands hospital drug bulletin. Ocular effects of serotonin antidepressants. North Metropolitan Health Service - Mental Health. 2016;23(2).

[ISSN 1323-1251]

Acan D, Kurtgoz P. Influence of selective serotonin reuptake inhibitors on ocular surface. Clin Exp Optom. 2017;100(1):83-86

Fujishiro J, Imanishi T, Onozawa K, Tsushima M. Comparison of the anticholinergic effects of the serotonergic antidepressants, paroxetine, fluvoxamine and clomipramine. Eur J Pharmacol. 2002;454(2-3):183-8

Sanchez C, EH, Montgomery SA. A comparative review of escitalopram, paroxetine, and sertraline: are they all alike? Int Clin Psychopharmacol. 2014; 29(4):185–196.

Hyttel J. Comparative pharmacology of Selective Serotonin Reuptake Inhibitors (SSRIs). Nord J Psychiatry. 1993;47(suppl 30):5-12.

Bazire S. Psychotropic drug directory - The professionals' pocket handbook and aide memoire. Malta: Gutenberg Press Ltd; 2012.

Ah-Kee EY, Egong E, Shafi A, Lim LT, Yim JL. A review of drug-induced acute angle closure glaucoma for non-ophthalmologists. Qatar Medical Journal. 2015;2015(1):6.

Erie JC, Brue SM, Chamberlain AM, Hodge DO. Selective serotonin reuptake inhibitor use and increased risk of cataract surgery: A population-based, case-control study. Am J Ophthalmol. 2014;158(1):192-197.

Lochhead J. SSRI-associated optic neuropathy. Eye. 2015;29(9):1233-1235.

Samant H, Samant P. Fluvoxamine-induced intracranial hypertension in a 10-year-old boy. Indian J Ophthalmol. 2018; 66(5):712–714.

Hutcheon ML. An unexpected case of swollen optic nerves. Am J Ther. 2011;18 (4):e126-9.

Ceylan ME, Evrensel A, Cömert G. Papilledema Due to Mirtazapine. Balkan Med J. 2016;33(3):363–365.

Luu C, Kiely P, Crewther D, Kowal L, Crewther S. Central and peripheral vision loss associated with nefazodone usage. Doc Ophthalmol. 2003;106(3):319-25.

Mason JO, Patel SA. Bull'S eye maculopathy in a patient taking sertraline. Retin Cases Brief Rep. 2015;9(2):131-3.

Sener EC, Kiratli H. Presumed sertraline maculopathy. Acta Ophthalmol Scand. 2001;79(4):428-30.

Agarwal A, Aggarwal K, Kumar A, Gupta V. Bilateral cystoid macular edema misdiagnosed as pars planitis in a patient on sertraline therapy. American Journal of Ophthalmology Case Reports. 2018;11: 135-138.