Escitalopram-Induced Uveal Effusions and Bilateral Angle Closure Glaucoma

Zelefsky, Joseph R.; Fine, Howard F; Rubinstein, Valeria J.; Hsu, Irene S.; Finger, Paul T.

doi:10.1016/j.ajo.2006.01.033

Cited by 51 publications

(45 citation statements)

References 4 publications

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“…56,57 The cause of ACAG in other groups of antidepressants is induced mydriasis by anticholinergic action of these medications in patients with narrow iridocorneal angle. Of tricyclic agents, amitryptiline (the most commonly reported agent) and imipramine 58 and of the non-tricyclic drugs, mianserin hydrochloride, 59 paroxetine, 57,60 fluoxetine, 61 maprotiline, 62,63 fluvoxamine, 64 venlafaxine, 65,66 citalopram, 67 and escitalopram 68 have been documented to be associated with ACAG attacks. Ritch et al 58 reported development of ACAG in four patients with occludable angles who received routinely prescribed doses of imipramine.…”

Section: Antidepressantsmentioning

confidence: 99%

Non-steroidal drug-induced glaucoma

Razeghinejad

Pro

Katz

2011

Eye

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Numerous systemically used drugs are involved in drug-induced glaucoma. Most reported cases of non-steroidal drug-induced glaucoma are closed-angle glaucoma (CAG). Indeed, many routinely used drugs that have sympathomimetic or parasympatholytic properties can cause pupillary block CAG in individuals with narrow iridocorneal angle. The resulting acute glaucoma occurs much more commonly unilaterally and only rarely bilaterally. CAG secondary to sulfa drugs is a bilateral non-pupillary block type and is due to forward movement of iris-lens diaphragm, which occurs in individuals with narrow or open iridocorneal angle. A few agents, including antineoplastics, may induce open-angle glaucoma. In conclusion, the majority of cases with glaucoma secondary to non-steroidal medications are of the pupillary block closed-angle type and preventable if the at-risk patients are recognized and treated prophylactically.

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Section: Antidepressantsmentioning

confidence: 99%

Non-steroidal drug-induced glaucoma

Razeghinejad

Pro

Katz

2011

Eye

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“…Studies revealed that the probability of glaucoma-especially AACG-is higher with SSRIs that have a stronger norepinephrine and serotonin reuptake inhibitor (17). Among SSRIs, sertraline has the highest potency in serotonin reuptake inhibition and is the most potent SSRI in the inhibition of norepinephrine reuptake after paroxetine (14).Yet, several cases of acute glaucoma were reported in patients treated with…”

Section: Introductionmentioning

confidence: 98%

“…Pharm Biomed Res 2017; 3(3): 32 paroxetine(9-13),citalopram (3,14), escitalopram (15),and sertraline (7). Recently, Lochhead has reported five cases of optic neuropathy in patients treated with paroxetine for 14 years(one case), citalopram for three and 10 years(two cases), fluoxetine for five years(one case), sertraline for six months and citalopram for six months(one case) (16).In most of the cases mentioned above, ocular complications of SSRIs occurred in women more than 50 years old and with underlying medical illness, and treated with drugs other than antidepressants (17).…”

Section: Pharmaceutical and Biomedical Researchmentioning

confidence: 99%

Effects of three months treatment with sertraline on intraocular pressure and cup-to-disc ratio in patients with anxiety disorders/mixed anxiety and depressive disorder/major depressive disorder and without underlying eye disease

et al. 2017

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Exposure to selective serotonin reuptake inhibitors causes pupillary dilator muscle stimulation, active mydriasis, rapid rise in the level of the intraocular pressure (IOP), damage to the optic nerve at the back of the eye, and ultimately leads to acute angle closure glaucoma. The aim of this study was to assess the effects of sertraline on the levels of IOP and cup-to-disc ratio (CDR) in patients with anxiety disorders or mixed anxiety and depressive disorder or major depressive under daily treatment with sertraline and without underlying eye disease for three months. In this study,30 eligible patients in the sertraline group and 30 healthy volunteers in the control group include the study and were referred to an ophthalmologist. Ophthalmologic examinations were assessed at the baseline and on the first and third months of the study. The average daily dose of sertraline was 95±2.5 mg.During the study, the IOP changes in the sertraline and control groups were 0.26±0.43 and 0.00±0.00 mmHg (p<0.001, p=NS) respectively and the CDR changes in sertraline and control groups were 0.03±0.05 and -0.01±0.05 (p=0.002, p=0.03) respectively. There was a significant difference in the IOP and CDR increasement between two groups ([F (1.7, 104.2) = 3.7, p = 0.03] and [F (2, 116) = 8.3, p < 0.001] respectively). In the present study, although changes in the IOP and CDR levels in the sertraline group were significant and was equal the daily change in the persons without glaucoma or patients with normal-tension glaucoma, but the slight and continuous increase in the IOP level associated with changes in pupil size and CDR, especially in patients at risk of glaucoma in the long term, can cause a disruption in hydrodynamic homeostasis. More studies with longer duration and different dosage of sertraline need to confirm our results.

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“…While 6 of these are related with paroxetine, 2 are citalopram, one is escitalopram, one is Fluoexetine, one is Fluvoxamine, there is not case notified on sertraline. 38,44,50,58,59,60 For this reason, paroxetine is responsible for most of the glaucoma cases. 38 In three of the six cases paroxetine is identified in geriatric patients (aged between 70-91), 2 of the cases are used in young patients who are hypermetropic and plateau iris configuration is identified in one patient.…”

Section: Antidepressants Tricyclic Antidepressant Agents (Tcas)mentioning

confidence: 99%

“…The use of escitalopram is stopped steroid treatment is started and the patient has shown complete recovery. 60 Fluoxetine is the first SSRI correlated with ACG. ACG has developed in a young man patient after using oral fluoxetine for 5 weeks.…”

Section: Antidepressants Tricyclic Antidepressant Agents (Tcas)mentioning

confidence: 99%

Psychotropic Drugs and Ocular Side Effects

Sönmez¹,

Aykan²

2013

Tjo

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Sum maryNowadays the number of patients using the types of drugs in question here has significantly increased. A study carried out in relation with the long term use of psychotropic drugs shows that the consumption of this group of drugs has substantially increased in terms of variety and quantity. This compilation is arranged in accordance with the ocular complications of psychotropic drugs in long term treatment profile of numerous patients to the results of related literature review. If the doctor and the patients are informed about the eye problems related to the use of psychotropic drugs, potential ocular complications can be easily prevented, supervised and controlled and can even be reversed. (

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Escitalopram-Induced Uveal Effusions and Bilateral Angle Closure Glaucoma

Cited by 51 publications

References 4 publications

Non-steroidal drug-induced glaucoma

Non-steroidal drug-induced glaucoma

Effects of three months treatment with sertraline on intraocular pressure and cup-to-disc ratio in patients with anxiety disorders/mixed anxiety and depressive disorder/major depressive disorder and without underlying eye disease

Psychotropic Drugs and Ocular Side Effects

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