Oral imipramine and acute angle closure glaucoma

Area of Science:

• Ophthalmology
• Pharmacology

Background:

• Imipramine hydrochloride is a commonly prescribed psychoactive medication.
• Narrow angles are a known risk factor for angle closure glaucoma.

Observation:

• Four patients with pre-existing narrow angles developed acute angle closure glaucoma after taking oral imipramine hydrochloride.
• The glaucoma episodes were temporally related to the ingestion of the medication.

Findings:

• Routine doses of imipramine hydrochloride precipitated acute angle closure glaucoma in susceptible individuals.
• Laser iridotomy proved to be a successful treatment for the induced glaucoma in all observed cases.

Implications:

• Clinicians should exercise caution when prescribing imipramine hydrochloride to patients with narrow angles.
• Ophthalmological monitoring is crucial for patients with narrow angles who are taking psychoactive medications like imipramine.