| SSRIs and intraocular pressure modifications: evidence, therapeutic implications and possible mechanisms. | |
| | |
MedLine Citation:
|
PMID: 15182218 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
SSRIs are the most commonly prescribed antidepressant drugs, in part because of their favourable safety profile compared with older antidepressants. However, the widespread use of SSRIs leads to an increased occurrence of rare adverse effects. This review, based on data from published experimental research, clinical studies and case reports, describes the role of serotonin in the control of intraocular pressure (IOP) and the evidence for IOP modifications in patients receiving SSRIs. In a small percentage of patients with depression, the cause of SSRI withdrawal has been the occurrence of ill-defined visual disturbances. It can be speculated that in some of these patients, the iatrogenic ocular alterations could have been due to changes in IOP. There have also been a limited number of case reports of acute attacks of glaucoma occurring during treatment with SSRIs. Although causality is not exactly specified, the relationship between SSRIs and this ocular adverse event is strongly implied. Nevertheless, in a small clinical study assessing the effect of a single dose of fluoxetine on IOP, the drug was shown to increase this parameter, although the effect was asymptomatic. The clinical signs of unexpected adverse drug effects are often disregarded, with the exception of those characterised by serious symptoms (such as acute angle-closure glaucoma in the case of IOP modifications). Also, the distribution of iridocorneal angle configurations in the general population implies that an adverse effect on IOP will be pauci- or asymptomatic in most patients (intermittent, sub-acute or progressive angle-closure glaucoma). As a result, it is likely that the incidence of SSRI-related IOP modifications is underestimated. Until the involvement of SSRIs in IOP modifications is better understood, ophthalmological consultations should be considered before starting and during treatment with any SSRI in patients with glaucomatous risk factors, especially those who are elderly. |
| | |
Authors:
|
Ciro Costagliola; Francesco Parmeggiani; Adolfo Sebastiani |
Related Documents
:
|
8491058 - Pharmacokinetic optimisation of tricyclic antidepressant therapy. 20566438 - Acute effects of serotonergic antidepressants on tryptophan metabolism and corticostero... 2931948 - Effect of tricyclic drugs on mitochondrial membrane. 22083788 - The role of abc efflux pump, rv1456c-rv1457c-rv1458c, from mycobacterium tuberculosis c... 16863548 - Should the presence of polymorphisms of cyp2c19 enzymes influence the choice of the pro... 16121058 - Cross-comparison of patch test and lymphocyte proliferation responses in patients with ... |
Publication Detail:
|
Type: Journal Article; Research Support, Non-U.S. Gov't; Review |
Journal Detail:
|
Title: CNS drugs Volume: 18 ISSN: 1172-7047 ISO Abbreviation: CNS Drugs Publication Date: 2004 |
Date Detail:
|
Created Date: 2004-06-08 Completed Date: 2004-08-02 Revised Date: 2006-11-15 |
Medline Journal Info:
|
Nlm Unique ID: 9431220 Medline TA: CNS Drugs Country: New Zealand |
Other Details:
|
Languages: eng Pagination: 475-84 Citation Subset: IM |
Affiliation:
|
Department of Ophthalmology, University of Ferrara, Ferrara, Italy. costaciro@libero.it |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Animals Antidepressive Agents / pharmacology*, therapeutic use Depression / drug therapy Eye / metabolism Glaucoma / drug therapy Humans Intraocular Pressure / drug effects*, physiology* Serotonin / physiology Serotonin Uptake Inhibitors / pharmacology*, therapeutic use |
| Chemical | |
Reg. No./Substance:
|
0/Antidepressive Agents; 0/Serotonin Uptake Inhibitors; 50-67-9/Serotonin |
| Comments/Corrections | |
Comment In:
|
CNS Drugs. 2006;20(4):327-9
[PMID:
16599650
]
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Time course of response to antidepressants in late-life major depression: therapeutic implications.
Next Document: Pharmacotherapy of alcohol dependence: a review of the clinical data.