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Citalopram associated with acute angle-closure glaucoma: case report.
Robert Croos1, Srinivasa Thirumalai, Sabit Hassan
1Department of Psychiatry, Prospect Park Hospital, Reading, RG30 4EJ, UK. Robert.Croos@berkshire.nhs.uk
BMC Ophthalmology
|October 6, 2005
Summary
Antidepressant Citalopram overdose can trigger acute angle-closure glaucoma, a rare condition. This case highlights the need for clinician awareness and further research into antidepressant-induced glaucoma.
Area of Science:
- Ophthalmology
- Pharmacology
- Toxicology
Background:
- Acute angle-closure glaucoma (AACG) is a rare but serious ocular condition.
- Antidepressant medications, particularly selective serotonin reuptake inhibitors (SSRIs), have been anecdotally linked to AACG.
- The exact pathophysiological mechanisms remain unclear, necessitating further investigation.
Observation:
- A case report details a 54-year-old female patient with depression and alcohol dependence.
- The patient developed AACG following an overdose of Citalopram, an SSRI antidepressant, combined with alcohol.
- The patient received medical treatment and bilateral YAG laser iridotomies, resulting in a full recovery.
Findings:
- Citalopram ingestion appears to be the underlying cause of AACG in this patient.
- Potential mechanisms include direct effects of Citalopram on iris or ciliary body muscles via serotonergic or anticholinergic pathways.
- This case underscores the importance of recognizing potential ocular risks associated with antidepressant use.
Implications:
- Clinicians should maintain a high index of suspicion for AACG in patients presenting with relevant symptoms after antidepressant use.
- Thorough ophthalmic examination before and after initiating antidepressant therapy is crucial.
- Further research is warranted to elucidate the specific mechanisms linking antidepressants to AACG and inform clinical practice.