Association of Selective Serotonin Reuptake Inhibitor Use and Acute Angle-Closure Glaucoma

Selective serotonin reuptake inhibitors (SSRIs) are the most widely used antidepressant medications for treating patients with depression; however, ocular complication has been noted occasionally. This study investigated the relationship between recent SSRI use and the risk of acute angle-closure glaucoma (AACG) in the ethnic Chinese population in Taiwan.

In this case-control study that involved using data from the Taiwan National Health Insurance database for the period 2000-2011, we recruited 1,465 patients with newly diagnosed AACG as case participants and 5,712 persons without glaucoma who were matched according to sex, age, and index year as controls. Immediate SSRI users were defined as patients who received at least 1 prescription for SSRIs within 7 days before the date of AACG diagnosis. Patients who received no SSRI prescriptions were defined as nonusers. Odds ratios (ORs) and 95% confidence intervals (CIs) were used to evaluate the risk of AACG associated with SSRI use.

After adjustment for confounding factors including non-SSRI antidepressant use and all comorbidities, the multivariable logistic regression model revealed that the adjusted OR of AACG was 5.80 for immediate SSRI users (95% CI, 1.89-17.9) when compared with nonusers. Further analysis, with nonusers as reference, resulted in an adjusted OR of 8.53 (95% CI, 1.65-44.0) for participants with a mean daily SSRI dose exceeding 20 mg.

Patients immediately using SSRIs have a 5.80-fold increased risk of AACG. Before prescribing SSRIs, clinicians should be aware of the potential AACG risks among elderly patients with depression.