Use of atypical antipsychotics and risks of cataract development in patients with schizophrenia: A population-based, nested case-control study

Chou, Po-Han; Chu, Chih‐Sheng; Lin, Ching Heng; Cheng, Chih‐Tao; Chen, Yi-Huey; Lan, Tsuo Hung; Huang, Min

doi:10.1016/j.schres.2016.03.027

Cited by 17 publications

(10 citation statements)

References 41 publications

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“…Атипичные нейролептики могут вызывать метаболический синдром, что потенциально может приводить к раннему образованию диабетической катаракты [4]. Однако ретроспективное исследование, проведенное на 4366 пациентах, не выявило взаимосвязи между приемом атипичных нейролептиков и повышенным риском развития катаракты [15].…”

Section: атипичные нейролептикиunclassified

Side effects of psychotropic drugs on eye

Petukhova¹,

Panov²,

Malygin³

et al. 2021

Russian Journal of Clinical Ophthalmology

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Any antipsychotics provoke more or less ocular complications. Some of them are relatively harmless (i.e., dark eyelids, conjunctival and corneal pigmentation, mydriasis, nystagmus, dry eye etc.). These adverse effects are resolved spontaneously after treatment discontinuation, drug switching, or prescribing additional therapy. However, the intake of both typical and atypical neuroleptics, lithium salts, some anticonvulsants (e.g., topiramate) is associated with high risks of vision loss. Moreover, in some patients these medications may result in blindness. The use of psychotropic drugs (e.g., tricyclic antidepressants or serotonin reuptake inhibitors) in patients with higher risk of acute angle closure is of particular concern. The association between phenothiazines and anticonvulsants and retinopathy, chlorpromazine and cataract, anticonvulsants and poor color vision and reduced contrast sensitivity is also important. Psychiatrists and ophthalmologists should consider potential ocular side effects in patients receiving psychotropic drugs. Knowing management algorithm for these conditions is also important. The number of recent publications on this issue is limited. Therefore, articles older than 10 years are sometimes used. Keywords: eye, visual organ, adverse effects, psychotropic drugs, neuroleptics, tricyclic antidepressants, selective serotonin reuptake inhibitors, glaucoma, retinopathy, cataract. For citation: Petukhova A.A., Panov A.A., Malygin Ya.V., Kazanfarova M.A. Side effects of psychotropic drugs on eye. Russian Journal of Clinical Ophthalmology. 2021;21(1):29–33. DOI: 10.32364/2311-7729-2021-21-1-29-33.

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Section: атипичные нейролептикиunclassified

Side effects of psychotropic drugs on eye

Petukhova¹,

Panov²,

Malygin³

et al. 2021

Russian Journal of Clinical Ophthalmology

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“…In a population-based, nested case-control study conducted in patients with schizophrenia, Chou et al 12 examined the association between antipsychotic drug use and a new diagnosis of cataract; analyses were adjusted for confounding variables, and antidepressant use was one such confounding variable. In the adjusted analysis, concurrent antidepressant use was associated with an increased risk of cataract (OR, 1.30; 95% CI, 1.09-1.55).…”

Section: Antidepressants and Cataract: Other Recent Findingsmentioning

confidence: 99%

“…In both of these studies, 12,13 as well as in 2 of the studies 5,6 included in the meta-analysis by Fu et al, 3 the association between antidepressant use and cataract was not the primary objective of the study. However, all 4 studies adjusted the analyses for cataract risk factors, and so the ORs for the association between antidepressant use and cataract were also adjusted ORs.…”

Section: Antidepressants and Cataract: Other Recent Findingsmentioning

confidence: 99%

“…In another nested case-control study, Chou et al 12 age-, sex-, and date-matched 2,144 schizophrenia patients with cataract with 2,222 controls. In analyses that adjusted for cataract risk factors, they found that there was no significant association between drug exposure and cataract for any of 9 atypical antipsychotics.…”

Section: Antipsychotic Drugs and Cataractmentioning

confidence: 99%

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Antidepressants, Mood Stabilizers, Antipsychotics, and the Risk of Cataract

Andrade

2019

J. Clin. Psychiatry

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Depression and Eye Diseases Zheng et al 1 described a systematic review and meta-analysis of depression and depressive symptoms in patients with eye diseases. They identified 28 relevant studies (pooled N = 6,589) and estimated that the prevalence of depression or depressive symptoms was 25% (95% CI, 20%-30%) in the pooled sample. The highest prevalence was found in patients with xerophthalmia (29%). The prevalence was also high in patients with glaucoma (25%), age-related macular degeneration (24%), and cataract (23%). Patients with eye disease were at higher risk of depression or depressive symptoms than healthy controls (odds ratio [OR], 1.59; 95% confidence interval [CI], 1.40-1.81). It is possible that the depression in patients with eye disease is a reaction to the ocular symptoms, and it is possible that the depression and eye disease occur coincidentally. It is also possible that depression and its correlates are a risk factor for at least some eye diseases. In this context, one possibility is that the antidepressant drugs used to treat depression increase the risk of cataract. Cataract Cataract is a disease of the eye that is characterized by impairment of vision resulting from the development of opacities in the lens. Cataract is the leading cause of blindness in low and middle income countries. The prevalence of cataract is about 4% in persons who are around 60 years of age and > 90% in those who are 80 years and older. Risk factors for cataract include older age, female sex, genetic vulnerabilities, lifestyle behaviors, medical comorbidities, and many others. 2 Psychotropic drugs, particularly antidepressant drugs, have recently been associated with cataract. This article critically examines the literature on the subject. Antidepressant Drugs and Cataract: Meta-Analysis Fu et al 3 described a systematic review and meta-analysis of studies that examined the development of cataract after antidepressant use. They searched electronic databases, reference lists, and other sources and identified 7 relevant case-control studies; 3 had been conducted in the United States, 2 in Canada, and 1 each in the United Kingdom and Taiwan. The pooled sample included 447,672 cases and 1,510,391 controls. Important findings from the meta-analysis 3 are presented in Table 1. In short, selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, and tricyclic antidepressants were each associated with a small but statistically significant increase in the risk of cataract. All 3 analyses were characterized by substantial heterogeneity; the authors did not examine the source of the heterogeneity. Among individual antidepressant drugs, the risk was significant for citalopram, fluoxetine, fluvoxamine, and venlafaxine but not for paroxetine, sertraline, escitalopram, duloxetine, and milnacipran; it is possible that many analyses were underpowered for the individual drugs. Visual inspection of the funnel plot suggested clear publication bias.

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“…The National Health Insurance (NHI) program of Taiwan covers most of the population, and most medical institutions in Taiwan, and is therefore one of the largest insurance databases in the world. The NHIRD contains all claims from ambulatory and inpatient care, and has provided valuable information for a variety of epidemiological studies [ 23 – 27 ]. Therefore, the aim of this study was to examine the risk of stroke in OCD patients treated with SSRIs using the NHIRD in Taiwan.…”

Section: Introductionmentioning

confidence: 99%

Use of Selective Serotonin Reuptake Inhibitors and Risks of Stroke in Patients with Obsessive Compulsive Disorder: A Population-Based Study

et al. 2016

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BackgroundPrevious research has suggested a link between antidepressants use and the development of cerebrovascular events, but there has never been any study investigating the risk of stroke in obsessive-compulsive disorder (OCD) patients treated with a selective serotonin reuptake inhibitor (SSRI).MethodsA retrospective observational cohort study was conducted using data from the National Health Insurance Database of Taiwan between the year of 2001 and 2009. A total of 527 OCD patients with 412 subjects in the SSRI use group and 115 in the non SSRI use group were included. Multivariable Cox proportional-hazards models were used to explore the associations between SSRI use and the occurrence of stroke, controlling for age, gender, concomitant medications, and comorbid medical illnesses.ResultsA total of nineteen OCD patients were diagnosed with new onset of stroke during the follow-up period including six cases in the SSRI group and thirteen in the non SSRI use group. SSRI use was demonstrated to be associated with a decreased risk of stroke (hazard ratio [HR] = 0.30; 95% confidence interval [CI] = 0.10–0.86, P = 0.02). The increase in age-related risk of strokes was 2.55 per decade (HR = 2.55; 95% CI = 1.74–3.75, P<0.001). Alternatively, sex, concomitant use of aspirin and non-steroidal anti-inflammatory drugs, and comorbidities with angina pectoris, diabetes mellitus, hypertension, and hyperlipidemia were not found to be associated with an increased risk for stroke in OCD patients.ConclusionsOur study showed that SSRI use was associated with decreased risk of stroke in OCD patients. Further investigation into the possible biological mechanisms underlying the relationship between stroke and SSRI use in OCD patients is warranted.

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Use of atypical antipsychotics and risks of cataract development in patients with schizophrenia: A population-based, nested case-control study

Cited by 17 publications

References 41 publications

Side effects of psychotropic drugs on eye

Side effects of psychotropic drugs on eye

Antidepressants, Mood Stabilizers, Antipsychotics, and the Risk of Cataract

Use of Selective Serotonin Reuptake Inhibitors and Risks of Stroke in Patients with Obsessive Compulsive Disorder: A Population-Based Study

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