Evaluation of major depressive disorder in patients receiving chronic treatment with topical timolol

It was the aim of this study to evaluate the prevalence of major depressive disorder (MDD) in chronic glaucoma patients on a topical β-blocker (timolol).

An observational case control study was performed.

The subjects recruited were divided into 3 groups. Group I included 98 patients with chronic glaucoma on topical β-blocker therapy, group II included 64 chronic glaucoma patients on prostaglandin analogues, and group III included 150 normal controls. All subjects were screened for MDD by the self-administered questionnaire Prime-MD Today (Primary Care Evaluation of Mental Disorders, New York, N.Y., USA).

The control group had a significantly higher age (p < 0.001) compared to the glaucoma patients on timolol or prostaglandin analogues; 9/98 patients (9.2%) on timolol, 1/64 patients (1.5%) on prostaglandins and 3/150 (2%) control subjects were screened positive for MDD. The odds ratios adjusted for age, sex and duration of glaucoma showed that patients on β-blocker therapy were 6.4 and 4.9 times more likely to have depression compared to those on prostaglandin analogues and control subjects, respectively.

Glaucoma patients on topical timolol should be screened for depression and referred for appropriate psychiatric consultation and treatment if indicated.