Sumatriptan dose increase-induced acute angle closure glaucoma in chronic migraine sufferer

Zormpas, Sokratis; Matsou, Artemis; Antunes, Diandra; Panos, Chris

doi:10.1136/bcr-2020-235880

Cited by 4 publications

(4 citation statements)

References 10 publications

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“…Various drugs that act on the nervous system are reportedly associated with AAC. Indeed, duloxetine, escitalopram, alprazolam, topiramate, and sumatriptan have been reported to induce AAC in previous case reports.…”

Section: Discussionmentioning

confidence: 99%

“…The major ocular risk factor is a shallow anterior chamber . In addition, several drugs have also been reported to be associated with AAC …”

Section: Introductionmentioning

confidence: 99%

“…5 In addition, several drugs have also been reported to be associated with AAC. [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] Understanding the association of drugs with AAC, a disease that can lead to sudden vision loss, is important in preventing the condition. If a patient needs to take a drug that is highly associated with AAC and has demographic and ocular risk factors for this disease, appropriate preventive measures, such as prophylactic laser peripheral iridotomy or cataract surgery, may reduce the risk of AAC occurrence.…”

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confidence: 99%

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Association of Drugs With Acute Angle Closure

Park

2022

JAMA Ophthalmol

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ImportanceAcute angle-closure (AAC) glaucoma is a sight-threatening disease and can reportedly occur in association with various drugs.ObjectiveTo identify drugs that are associated with AAC glaucoma occurrence and evaluate the risk of AACassociated with each drug.Design, Setting, and ParticipantsA case-crossover study was conducted using the Health Insurance Review and Assessment Service database, which contains medical information of the entire Korean population. Patients who were first diagnosed with AAC and treated between 2013 and 2019 were identified using diagnostic and procedure codes. All drugs that the study participants were prescribed as well as prescription dates during the period of 1 to 180 days before the onset of AAC were extracted from the database. For each patient, 1 to 30 days before onset was considered the hazard period, and 91 to 180 days before AAC onset was considered the control period.Main Outcomes and MeasuresDrugs associated with AAC and odds (calculated as odds ratios [ORs] with 95% CIs) of AAC development associated with each identified drug.ResultsA total of 949 drugs that were prescribed to 13 531 patients with AAC (mean [SD] age, 66.8 [10.6] years; 9585 [70.8%] female) during the period of 1 to 180 days before the onset of AAC were analyzed. A total of 61 drugs were found to be associated with AAC, among which sumatriptan (OR, 12.60 [95% CI, 4.13-38.44]) was associated with the highest odds of AAC development, followed by topiramate (OR, 5.10 [95% CI, 2.22-11.70]) and duloxetine (OR, 4.04 [95% CI, 2.95-5.54]). The median (IQR) period from prescription of the drug to the onset of AAC for the 61 drugs was 11.9 days (10.9-12.8). A number of drugs not previously considered to be associated with AAC, including lactulose (OR, 2.81 [95% CI, 1.72-4.61]) and metoclopramide (OR, 2.52 [95% CI, 1.95-3.25]), were identified.Conclusions and RelevanceResults of this case-crossover study suggest a need to consider AAC risk in patients taking any of the 61 drugs found to be associated with AAC.

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Section: Discussionmentioning

confidence: 99%

“…The major ocular risk factor is a shallow anterior chamber . In addition, several drugs have also been reported to be associated with AAC …”

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Association of Drugs With Acute Angle Closure

Park

2022

JAMA Ophthalmol

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“…There exist case reports of duloxetine and venlafaxine causing ACG (20). Sumatriptan has also been reported to influence ACG [21,22]. The proposed mechanism is drug-induced malignant glaucoma, forward rotation of the lens-iris diaphragm, zonular relaxation and increased curvature of the lens.…”

Section: Serotonergic Agentsmentioning

confidence: 99%

Drug-Induced Acute Angle-Closure Glaucoma: Raising your Index of Suspicion

An¹,

Bahajjaj

Lateef

et al. 2021

BJSTR

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Aim: To highlight polypharmacy as a risk factor for acute angle-closure glaucoma (AACG) in the emergency department (ED) with a brief literature review and propose an approach to early identification of AACG in the critically ill patients.Background: Acute angle-closure glaucoma (AACG) is an ophthalmological emergency that can lead to rapid, irreversible vision loss as a result of ischemia and atrophy of the optic nerve. Various drugs have been known to precipitate an acute angleclosure attack including adrenergics, anticholinergics, antihistamines, cholinergics, sulfonamides and serotonergic agents. Drug-induced AACG is usually observed in patients with predisposing risk factors. Anatomical risk factors include shallow chamber depth, small anterior segment and plateau iris configuration. Demographic risk factors include advanced age, family history, female gender and Asian ethnicity. Increasing rates of polypharmacy in the population, especially amongst the elderly, result in many patients with these predisposing risk factors also being on drugs that may precipitate AACG. More importantly, many drugs routinely prescribed acutely in the ED tend to overlap with the drugs reported to trigger AACG. Lastly, when an unresponsive patient presented to the ED, a diagnosis of AACG might be missed if the patient is unable to relay the classical symptoms. These three factors necessitate a high index of suspicion to ensure that a sight-threatening cause is not missed out in our patients.

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Sumatriptan

2021

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Sumatriptan dose increase-induced acute angle closure glaucoma in chronic migraine sufferer

Cited by 4 publications

References 10 publications

Association of Drugs With Acute Angle Closure

Association of Drugs With Acute Angle Closure

Drug-Induced Acute Angle-Closure Glaucoma: Raising your Index of Suspicion

Sumatriptan

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