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Abstract #46045 Published in IGR 13-2
Antidepressants and risk of acute angle closure glaucoma in older adults
Seitz D; Campbell R; Bell C; Gill S; Gruneir A; Herrmann N; Anderson G; Rochon PAmerican Journal of Geriatric Psychiatry 2011; 19: 95-96
Introduction: Acute angle closure glaucoma (AACG) is an ocular emergency that may be precipitated by certain types of medications. Antidepressants are commonly prescribed to older adults and a number of ocular processes that may predispose individuals to AACG are affected by antidepressants. We investigated the association between antidepressant exposure and AACG among older adults. Methods: We used a case-crossover study design to investigate the association between recent exposure to antidepressants and development of AACG. We identified all cases of AACG among adults aged 66 years or older between 1997 - 2009 in the province of Ontario using population-based administrative databases. We identified intermittent users of antidepressant medications through prescription drug claims in the year preceding AACG. We classified antidepressant exposure into three categories: anticholinergic antidepressants; mixed serotonergic/noradrenergic antidepressants; and, primarily serotonergic antidepressants. We determined antidepressant exposure in the time period immediately prior to AACG (hazard period: 0 - 30 days) and compared it to antidepressant exposure in two control periods preceding AACG (61 - 90 days, 91 - 120 days). We used conditional logistic regression to determine the odds ratio (OR) for antidepressant exposure in the hazard time period compared to the control time periods. Results: A total of 5,642 cases of AACG occurred during the study period. The mean age of the study population was 74.4 years and 66% were female. Overall, 5.6% of individuals were intermittent users of antidepressants in the year preceding AACG. The OR for any antidepressant exposure in the time period immediately preceding AACG was 1.76 (95% CI: 1.22 - 2.53). An increased risk of AACG was observed in the serotonergic/noradrenergic subgroup (OR = 2.71; 95% CI: 1.04 - 7.05) while the results for the anticholinergic (OR = 1.58; 95% CI : 0.99 - 2.50) and primarily serotonergic (OR = 1.79; 95% CI: 0.82 - 3.91) subgroups were not statistically significant. Conclusions: Recent exposure to antidepressants is associated with an increased risk of AACG. However, most cases of AACG are not associated with use of antidepressants. Clinicians should monitor patients for the development of this potentially serious adverse event after initiating antidepressant therapy. Further large-scale studies of the potential adverse ocular events associated with antidepressants are required.
D. Seitz. Queen's University, Kingston, Canada.
Classification:
9.3.1 Acute primary angle closure glaucoma (pupillary block) (Part of: 9 Clinical forms of glaucomas > 9.3 Primary angle closure glaucomas)
11.15 Other drugs in relation to glaucoma (Part of: 11 Medical treatment)