Le Gia Han, Wong Sabrina, Kwan Angela T H, Rosenblat Joshua D, Mansur Rodrigo B, Teopiz Kayla M, Ho Roger, Rhee Taeho Greg, Vinberg Maj, Cao Bing, Liao Sonya, McIntyre Roger S
Institute of Medical Science, University of Toronto, Toronto, ON, Canada.
Mood Disorder Psychopharmacology Unit, University Health Network, Toronto, ON, Canada.
CNS Spectr. 2024 Dec;29(6):682-696. doi: 10.1017/S1092852924002360. Epub 2025 Jan 6.
Antidepressants are commonly prescribed for mood disorders. Epidemiological studies suggest antidepressant use may be associated with cataracts and glaucoma. We aim to investigate the association between antidepressants and cataracts and glaucoma.
Data was collected from the United States Food and Drug Administration Adverse Event Reporting System. Reporting odds ratio (ROR) and Bayesian information components (IC) were calculated for antidepressants (ie, selective serotonin reuptake inhibitors [SSRIs], selective norepinephrine reuptake inhibitors [SNRIs], serotonin-norepinephrine-dopamine reuptake inhibitors, serotonin modulators and stimulators, serotonin antagonists and reuptake inhibitors [SARIs], norepinephrine reuptake inhibitors, norepinephrine-dopamine reuptake inhibitors, tricyclic antidepressants [TCAs], tetracyclic antidepressants [TeCAs], and monoamine oxidase inhibitors [MAOIs]). The reference agent was acetaminophen.
TeCAs and MAOIs were significantly associated with a decreased risk of cataracts (ROR = 0.11-0.65 and 0.16-0.69, respectively). TCAs, brexanolone, esketamine, and opipramol reported an increased cataract risk (ROR = 1.31-12.81). For glaucoma, SSRIs, SNRIs, SARIs, TCAs, MAOIs, and other investigated antidepressants reported significant RORs ranging from 1.034 to 21.17. There was a nonsignificant association of angle closure glaucoma (ACG) and open angle glaucoma (OAG) with the investigated antidepressants.
For adverse event cases, multiple suspected product names are listed, and as cases are not routinely verified, there may be a possibility of duplicate reports and causality cannot be established.
Most of the investigated antidepressants were associated with a lower risk of cataract reporting. TCAs, brexanolone, esketamine, and opipramol were associated with greater odds of cataract. For most antidepressants, there was an insignificant increase in reports of ACG and OAG.
抗抑郁药常用于治疗情绪障碍。流行病学研究表明，使用抗抑郁药可能与白内障和青光眼有关。我们旨在研究抗抑郁药与白内障和青光眼之间的关联。
数据收集自美国食品药品监督管理局不良事件报告系统。计算了抗抑郁药（即选择性5-羟色胺再摄取抑制剂[SSRIs]、选择性去甲肾上腺素再摄取抑制剂[SNRIs]、5-羟色胺-去甲肾上腺素-多巴胺再摄取抑制剂、5-羟色胺调节剂和刺激剂、5-羟色胺拮抗剂和再摄取抑制剂[SARIs]、去甲肾上腺素再摄取抑制剂、去甲肾上腺素-多巴胺再摄取抑制剂、三环类抗抑郁药[TCAs]、四环类抗抑郁药[TeCAs]和单胺氧化酶抑制剂[MAOIs]）的报告比值比（ROR）和贝叶斯信息成分（IC）。对照药物为对乙酰氨基酚。
TeCAs和MAOIs与白内障风险降低显著相关（ROR分别为0.11 - 0.65和0.16 - 0.69）。TCAs、布雷沙诺龙、艾司氯胺酮和奥匹哌醇报告显示白内障风险增加（ROR = 1.31 - 12.81）。对于青光眼，SSRIs、SNRIs、SARIs、TCAs、MAOIs和其他研究的抗抑郁药报告的显著ROR范围为1.034至21.17。所研究的抗抑郁药与闭角型青光眼（ACG）和开角型青光眼（OAG）之间的关联不显著。
对于不良事件病例，列出了多个可疑产品名称，且由于病例未常规核实，可能存在重复报告的可能性，无法确定因果关系。
大多数研究的抗抑郁药与较低的白内障报告风险相关。TCAs、布雷沙诺龙、艾司氯胺酮和奥匹哌醇与更高的白内障发病几率相关。对于大多数抗抑郁药，ACG和OAG的报告增加不显著。
