Influence of selective serotonin reuptake inhibitors on ocular surface

Acan, Durgul; Kurtgoz, Pelin

doi:10.1111/cxo.12415

Cited by 20 publications

(21 citation statements)

References 34 publications

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“…Accumulating evidence suggests that SSRIs are closely related to the risk of DED. 8,9 Benzodiazepines and some other antidepressants, including tricyclic, noradrenergic, and specific serotonergic antidepressants, are not associated with DED. 4 Importantly, our previous study 10 indicates that SSRIs are independent risk factors for DED.…”

mentioning

confidence: 99%

Selective Serotonin Reuptake Inhibitors Aggravate Depression-Associated Dry Eye Via Activating the NF-κB Pathway

Zhang

Yin

Yue

et al. 2019

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. Our study aimed to evaluate the side effects of selective serotonin reuptake inhibitors (SSRIs) on the ocular surface. METHODS. Twenty patients with depression and dry eye disease (DED) were randomly picked to receive SSRI treatment, whereas another 20 patients received placebo treatment. The serotonin, inflammatory cytokine, and proapoptotic protein levels were determined by using protein chip, qRT-PCR, and ELISA analyses. A rat depression model was established, and SSRIs were applied for 3 or 6 weeks. Tear production and corneal epithelial barrier function were evaluated. The serotonin and inflammatory cytokine levels were analyzed by qRT-PCR, immunohistochemical staining, and ELISA. Human corneal epithelial cells were subjected to serotonin, a HTR antagonist, and/or an NF-jB signaling inhibitor. The inflammatory cytokine and proapoptotic protein levels were determined by qRT-PCR, Western blot analysis, and ELISA. The cell apoptosis rate was assessed by using flow cytometry. RESULTS. The SSRI group had higher tear serotonin levels and more serious inflammation and cell apoptosis on the ocular surface. In the rat depression model, depression decreased tear secretion and increased IL-1b and TNF-a production, whereas the serotonin, TLR2, and TLR4 levels were not increased. SSRI aggravated DED, disrupted the corneal epithelial barrier, and promoted an inflammatory response on the ocular surface by increasing the tear serotonin levels. In addition, serotonin induced an inflammatory response and cell apoptosis in corneal epithelial cells by activating NF-jB signaling. CONCLUSIONS. SSRIs aggravate depression-associated DED via activating the NF-jB pathway. The antagonist of HTRs or the inhibitor of NF-jB signaling presents a potential therapeutic strategy for depression-associated DED. (Trial registration number, ChiCTR1800015592).

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confidence: 99%

Selective Serotonin Reuptake Inhibitors Aggravate Depression-Associated Dry Eye Via Activating the NF-κB Pathway

Zhang

Yin

Yue

et al. 2019

Invest. Ophthalmol. Vis. Sci.

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“…Both Group 1 and 2 underwent detailed psychiatric and ophthalmological examination. The results showed no significant differences between the groups in terms of age and sex (P > 0.05) (25). The most commonly used SSRI among Group 1 was fluoxetine and the period of usage ranged between 2 and 120 months.…”

Section: Psychopharmacology In Ophthalmologymentioning

confidence: 79%

“…In a cross-sectional observational study by Acan et al (2016), the authors aimed to determine the influence of selective serotonin reuptake inhibitors (SSRIs) on ocular surface and tear film stability. 36 patients (Group 1) and 36 healthy volunteers (Group 2) were enrolled (25). Group 1 was composed of patients in clinical remission of depression and/or anxiety to exclude the possible effect of the psychiatric disease on ocular disease when patients were using SSRIs.…”

Section: Psychopharmacology In Ophthalmologymentioning

confidence: 99%

“…Antidepressants could induce dry eye disease, as most of them inhibit amine (norepinephrine and serotonin) reuptake pumps, thus increasing functional amine-dependent synaptic transmission. In addition, serotonin receptors have been identified in the corneal and conjunctival epithelia, meaning that altered concentrations of serotonin by the use of SSRIs could affect the eyes (25).…”

Section: Psychopharmacology In Ophthalmologymentioning

confidence: 99%

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The Interface Between Psychiatry and Ophthalmology

Sadykov

Studnička

Hosák

et al. 2019

Acta Med. (Hradec Kralove, Czech Repub.)

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Objective: The aim of this article is to review the interface between psychiatry and ophthalmology at several levels, such as the influence of psychopharmacology on eye disorders, the occurrence of psychiatric symptoms in eye diseases, and the neuroophthalmological examination methods supporting the validity of psychiatric diagnoses. Materials and Methods: We searched the PubMed computer database for the key words “Psychiatry” and “Ophthalmology” on the 28th of August, 2018 to obtain relevant articles which were consequently summarized. Results: The results showed that most patients with ocular disease simultaneously have one or more psychiatric symptoms. We also found a prevalence of eye-related side effects in patients who use psychiatric drugs. At the same time, we observed that some ophthalmology methods of diagnostics can be used as diagnostic tools in psychiatry. Conclusions: Most studies showed a significant relation between psychiatry and ophthalmology, such as eye symptoms and diseases following long-term use of psychotropics as well as psychiatric symptoms and syndromes in patients with eye disorders. Our review may be beneficial to psychiatrists, ophthalmologists, and, last but not least, the patients themselves.

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“…Previous studies indicated that medications prescribed for psychiatric conditions may precipitate DED 5,6,45. Most of the antidepressant drugs, such as tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs) or serotonin–norepinephrine reuptake inhibitors (SNRIs) have antagonistic effects on muscarinic receptors, which can cause adverse effects, including DED, dry mouth and constipation 46.…”

Section: Association With Psychiatric Problemsmentioning

confidence: 99%

Association of dry eye disease with psychiatric or neurological disorders in elderly patients

Han

Yang²,

Hyon³

et al. 2017

CIA

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Dry eye disease (DED) is a common disease that can impair quality of life significantly. Its prevalence increases with advancing age, and the economic burden of the disease on both a patient and the society is increasing with elongation of life expectancy. The diagnosis and treatment of DED are often difficult due to the discordance between symptoms and signs of the disease. Recent studies have suggested the role of neurological or psychological factors in the development of dry eye symptoms and discrepancy of the symptoms and signs, particularly in elderly patients. In this review, the authors discuss the association of DED with various psychiatric and neurological disorders. In addition to psychiatric conditions, including depression, anxiety, stress, posttraumatic stress disorder and sleep disorders, medications for the psychiatric disorders have association with DED. Neurological disorders, such as neuropathic pain, chronic pain syndrome, peripheral neuropathy and several central nervous system disorders, are related to DED. Treatment of DED, combined with psychiatric or neurological disorders, is also discussed. Attention should be paid to the DED patients with discordant symptoms and signs, and unsatisfactory response to conventional treatment for associated psychiatric or neurological disorders, as well as an integrated treatment approach, could be helpful for these patients.

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Influence of selective serotonin reuptake inhibitors on ocular surface

Abstract: Selective serotonin reuptake inhibitor usage might affect ocular surface by affecting tear film stability and such an association should be kept in mind by both psychiatrists and ophthalmologists in clinical practice.

Cited by 20 publications

References 34 publications

Selective Serotonin Reuptake Inhibitors Aggravate Depression-Associated Dry Eye Via Activating the NF-κB Pathway

Selective Serotonin Reuptake Inhibitors Aggravate Depression-Associated Dry Eye Via Activating the NF-κB Pathway

The Interface Between Psychiatry and Ophthalmology

Association of dry eye disease with psychiatric or neurological disorders in elderly patients

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