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| Anti-Depressant Use Raises Cataract Risk |
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| SciMed - Healthcare | |||
| TS-Si News Service | |||
| Wednesday, 10 March 2010 09:00 | |||
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Vancouver, BC, CAN. People undergoing severe stress can resort to the use of anti-depressant drugs, but some of the same medications are associated with an increased chance of developing cataracts, according to a new statistical study by researchers at the University of British Columbia (UBC), Vancouver Coastal Health Research Institute and McGill University. More than 200,000 Quebec residents aged 65 and older were in the database, with statistical relationships between a diagnosis of cataracts or cataract surgery and the class of selective serotonin reuptake inhibitors (SSRIs), as well as between cataracts and specific drugs within that class. Published in the journal Ophthalmology, the study does not prove causation but only reveals an association between the use of SSRIs and the development of cataracts. The study could not account for the possibility of smoking — which is a risk factor for cataracts — and additional population-based studies are needed to confirm these findings, the researchers say.Symptoms of depression are also observed among members of the pre-op transsexual population, which may put them at risk depending on any medications that might be prescribed to alleviate the condition. This study of statistical relationships is the first to establish a link between this class of drugs and cataracts in humans. Previous studies in animal models had demonstrated that SSRIs could increase the likelihood of developing the condition.
"When you look at the trade-offs of these drugs, the benefits of treating depression — which can be life-threatening — still outweigh the risk of developing cataracts, which are treatable and relatively benign," says Dr. Mahyar Etminan, lead author of the article, a scientist and clinical pharmacist at the Centre for Clinical Epidemiology at Vancouver Coastal Health Research Institute and an assistant professor in the Dept. of Medicine at UBC. Researchers found patients taking SSRIs were overall 15 per cent more likely to be diagnosed with cataracts or to have cataract surgery. The degree of risk among specific and different types of SSRIs varied considerably. Taking fluvoxamine (Luvox) led to a 51 per cent higher chance of having cataract surgery, and venlafaxine (Effexor) carried a 34 per cent higher risk. No connection could be made between fluoxetine (Prozac), citalopram (Celexa), and sertraline (Zoloft) and having cataract surgery. Co-author Dr. Frederick S. Mikelberg, professor and head of the Dept. of Ophthalmology and Visual Sciences at UBC and head of the Dept. of Ophthalmology at Vancouver General Hospital, notes that the average time to develop cataracts while taking SSRIs was almost two years. "While these results are surprising, and might inform the choices of psychiatrists when prescribing SSRIs for their patients, they should not be cause for alarm among people taking these medications," Mikelberg says. SSRIs, the third most prescribed class of drugs in the world, block the uptake of the FundingThe research was supported in part by the Canadian National Institute for the Blind, with Dr. Brophy receiving financial support from the Fonds de la Recherche en Santé du Québec. Co-author Dr. James M. Brophy, of the McGill University Dept. of Medicine, provided the database used for the study.
CitationSelective Serotonin Reuptake Inhibitors and the Risk of Cataracts: A Nested Case-Control Study. Mahyar Etminan, Frederick S. Mikelberg and James M. Brophy. Ophthalmology 2010. ePub ahead of print. doi:10.1016/j.ophtha.2009.11.042
Abstract Objective. Older-generation antidepressants have been associated with increasing the risk of cataracts. Although animal studies have alluded to a potential link between selective serotonin reuptake inhibitors (SSRIs) and the development of cataracts, no large population based-study has addressed this potential association. This study sought to quantify the risk of cataracts with SSRIs by conducting a pharmacoepidemiologic study using the linked administrative databases in the province of Quebec, Canada. Design. Nested case-control study. Participants. A cohort of subjects who had received a coronary revascularization procedure from 1995 through 2004 in the province of Quebec, Canada. Methods. Using an administrative data set, a case-control study was conducted within a cohort of Quebec residents who had received a coronary revascularization procedure from 1995 through 2004. Cases were defined as those with the first diagnosis of a cataract diagnosed by an ophthalmologist. For each case, 10 controls were selected and matched to the cases by index date, age, and cohort entry. Crude and adjusted rate ratios (RRs) and corresponding confidence intervals (CIs) were computed for current use of SSRIs. Rate ratios were adjusted for gender, corticosteroid use, statins, high blood pressure, antihypertensives, and antidiabetics. Main Outcome Measures. First International Classification for Disease (Ninth Revision) code for a cataract diagnosed by an ophthalmologist. Results. Eighteen thousand seven hundred eighty-four cases and 187 840 controls met our study inclusion criteria. The adjusted RR for cataracts among current users of SSRIs was 1.15 (95% CI, 1.08–1.23). The risk of cataracts was highest with fluvoxamine (RR, 1.39; 95% CI, 1.07–1.80), followed by venlafaxine (RR, 1.33; 95% CI, 1.14–1.55) and paroxetine for cataract surgery (RR, 1.23; 95% CI, 1.05–1.45). The average time to diagnosis of cataracts while on SSRI therapy was 656 days. Conclusions. A possible association was found between current exposure to SSRIs, especially fluvoxamine and venlafaxine, and a future diagnosis of cataracts. The possibility that this observation may be the result of the effect of smoking, which could not be controlled for in the study, cannot be excluded. Future studies are needed to confirm this association in other populations.
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| Last Updated on Wednesday, 10 March 2010 14:19 |
neurotransmitter
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