Are Schizophrenia or Antipsychotic Drugs a Risk Factor for Cataracts?

Ruigómez, Ana; Rodrı́guez, Luis A. Garcı́a; Dev, Vikram J.; Arellano, Félix; Raniwala, Joher

doi:10.1097/00001648-200011000-00002

Cited by 43 publications

(26 citation statements)

References 11 publications

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“…However, the validity of a recorded diagnosis of cataract in the GPRD has been found to be high (94%) 22 and we were able to ensure some uniformity in diagnostic pattern by matching cases and controls on the general practice used. In spite of this, one of the major challenges facing epidemiological research of cataract is the problem of case ascertainment.…”

Section: Discussionmentioning

confidence: 99%

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Hormone replacement therapy and cataract: a population-based case–control study

Aina

Smeeth

Hubbard

et al. 2005

Eye

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Purpose Laboratory studies have suggested that hormone replacement therapy (HRT) may protect against the development of cataract, but epidemiological studies in humans have thus far been inconclusive. The aim of this study was to assess the association between hormone replacement therapy and cataract. Methods Population-based case-control study using data from the General Practice Research Database in the UK. Participants were 10 000 women aged 45 years and over with diagnosed cataract and 10 000 controls matched on age, general practice, and calendar period. Results The crude odds ratio for the association between cataract and ever-use of oestrogen-only hormone replacement therapy was 1.13 (95% CI 0.99-1.29). This reduced to 0.81 (95% CI 0.71-0.94) after adjustment for consultation rate. Similarly, the crude odds ratio for the association between cataract and ever-use of a formulation containing oestrogen and progestogen was 1.18 (95% CI 1.01-1.39), reducing to 0.86 (95% CI 0.72-1.02) after adjustment for consultation rate. Conclusions Oestrogen-only and oestrogenprogestogen hormone replacement therapies are associated with a small reduced risk of cataract. This data adds to the growing body of evidence on the effects of HRT on health. All potential benefits and risks of this therapy should be taken into account when considering its use.

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Section: Discussionmentioning

confidence: 99%

“…The diagnosis of cataract was confirmed by hospital consultant ophthalmologists and the information forwarded to the general practitioner who records this in the medical records. 22 The date of diagnosis was referred to as the index date. Cases were required to have at least 180 days of observation prior to the index date.…”

Section: Methodsmentioning

confidence: 99%

Hormone replacement therapy and cataract: a population-based case–control study

Aina

Smeeth

Hubbard

et al. 2005

Eye

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“…Certain AAP may be associated with an increased risk of ocular lens opacities. An epidemiologic study that used the UK General Practice Research Database did not find an overall increase in the risk for cataracts among patients treated with antipsychotics (41).…”

Section: Cataractmentioning

confidence: 93%

Side effects of atypical antipsychotics: a brief overview

2008

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Patients with schizophrenia suffer from increased rates of multiple medical problems, due to their lifestyle (high smoking prevalence, high-fat diet), inherent neglect of personal care, and barriers to treatment of physical illness (1). A further important contributor to adverse health outcomes is the side effect profile of antipsychotic medications. Since the introduction of the second generation or atypical antipsychotics (AAP), these agents have been widely prescribed for the management of patients with schizophrenia, bipolar disorders, other psychotic disorders or conditions with severe behavioral disturbance. The increasing use of AAP is in part due to their lower propensity to induce extrapyramidal symptoms and tardive dyskinesia compared to typical antipsychotics. Now, more than 15 years after the first atypical antipsychotic entered the market, psychiatrists have gradually come to realize that while extrapyramidal symptoms and tardive dyskinesia occur less frequently with atypical agents, these medications may present a different set of adverse effects. The quality of available evidence for the association of specific antipsychotics with particular side effects varies considerably. In this article, we review the recent findings concerning weight gain, diabetes mellitus (DM), hyperlipidemia, QTc interval prolongation, myocarditis, sexual side effects, extrapyramidal side effects and cataract in patients receiving AAP. WEIGHT GAINForty to sixty-two percent of people with schizophrenia are overweight or obese. Obesity increases these patients' risk for cardiovascular morbidity and mortality. In addition, excessive weight and obesity can have important effects on an individual's adjustment in the community, adherence to prescribed medication, ability to participate in rehabilitation efforts, and self-image (2).Treatment with first-and second-generation antipsychotics can contribute to weight gain (3-5). A meta-analysis by Allison and Casey (4) provided an estimate of the mean weight gain in patients receiving standard doses of antipsychotics over a 10-week period: the mean increases were 4.45 kg with clozapine, 4.15 kg with olanzapine, 2.92 kg with sertindole, 2.10 kg with risperidone, and 0.04 kg with ziprasidone. Data on quetiapine have been variable, but it seems that the weight gain liability on this drug may be similar to that of risperidone (6). Weight gain with olanzapine at the commonly used dose of 15mg/day may exceed 10 kg during the first year of treatment (7). On the other hand, weight gain seems to be dose-dependent: Rondanelli et al (8) reported no change in weight in elderly patients who received 1.4 mg/day risperidone or 4.4 mg/day olanzapine or 75 mg/day quetiapine over a 12-month period.Marder et al (9) recommended that the patient's body mass index (BMI) should be recorded before medication initiation or change and at every visit for the first 6 months. The patient should be weighed (and the BMI recorded) at least quarterly when he stabilizes, and more often if he is overweight. BMI monito...

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“…The GPRD is a computerized database comprising the medical records of more than 10 million UK patients registered with a primary care physician. Previous epidemiological studies based on GPRD data have shown that it can be used to study patients with MS, 22 cataract, 23 and longitudinal exposure to oral GCs. 24,25 Our study was approved by the Independent Scientific Advisory Committee (ISAC) of the Medicines and Healthcare Product Regulatory Agency (MHRA) of the United Kingdom, protocol number 09_098.…”

Section: Data Sourcementioning

confidence: 99%

Risk of cataract and glaucoma in patients with multiple sclerosis

et al. 2011

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Background: The aim of the study was to evaluate whether multiple sclerosis (MS) is associated with risk of cataract or glaucoma. Methods:We conducted a population-based cohort study utilizing the UK General Practice Research Database (1987Database ( -2009 linked to the national hospital registry of England (1997England ( -2008. Incident MS patients (5576 cases) were identified and each was matched to six patients without MS (controls) by age, gender, and practice. Cox proportional hazard models were used to estimate hazard ratios (HRs) of incident cataract and glaucoma in MS. Time-dependent adjustments were made for age, history of diseases and drug use. Results: MS patients had no overall increased risk of cataract, adjusted (adj.) HR 1.15 (95% CI 0.94-1.41) or glaucoma, adj. HR 1.02 (95% CI 0.78-1.33). Risk of cataract (adj. HR 2.45 (95% CI 1.56-3.86)) and glaucoma (adj. HR 1.70 (95% CI 1.01-2.86)) was significantly greater in patients < 50 years, particularly in men < 50 years: cataract, adj. HR 4.23 (95% CI 2.22-8.05) and glaucoma, adj. HR 2.76 (95% CI 1.28-5.93). Conclusion: This is the first study which showed that the risk of cataract and glaucoma is elevated in MS patients younger than 50 years, particularly men.

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Are Schizophrenia or Antipsychotic Drugs a Risk Factor for Cataracts?

Cited by 43 publications

References 11 publications

Hormone replacement therapy and cataract: a population-based case–control study

Hormone replacement therapy and cataract: a population-based case–control study

Side effects of atypical antipsychotics: a brief overview

Risk of cataract and glaucoma in patients with multiple sclerosis

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