Depression and Anxiety After Topical Carbonic Anhydrase Inhibitors.

Area of Science:

• Ophthalmology
• Psychiatry
• Pharmacology

Background:

• Glaucoma is a leading cause of irreversible blindness worldwide.
• Topical carbonic anhydrase inhibitors (CAIs) are commonly prescribed for glaucoma management.
• The potential neuropsychiatric side effects of topical CAIs require further investigation.

Purpose of the Study:

• To examine the association between the use of topical carbonic anhydrase inhibitors (CAIs) and the incidence of depression and anxiety disorders in patients diagnosed with glaucoma.

Main Methods:

• A retrospective, multicenter cohort study involving glaucoma patients aged 40 years and older.
• Propensity score matching (PSM) was employed to balance covariates between topical CAI users and a control group.
• Cox proportional hazards models were utilized to determine adjusted hazard ratios (aHRs) for depression, antidepressant initiation, and anxiety disorders.

Main Results:

• Topical CAI use was significantly associated with increased new-onset depression at 3 months (1.42% vs. 0.77%), 6 months (2.46% vs. 1.41%), and 1 year (4.05% vs. 2.47%).
• Antidepressant prescriptions were also higher in the topical CAI group across all time points.
• Anxiety disorders occurred more frequently in patients using topical CAIs (all P < 0.001).

Conclusions:

• Topical CAI treatment in glaucoma patients is linked to a greater risk of developing depression, initiating antidepressant therapy, and experiencing anxiety disorders within the first year.
• Clinical monitoring for neuropsychiatric adverse effects is essential for glaucoma patients undergoing topical CAI therapy.