Blurred Vision and Antidepressants

Blurred Vision
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Blurred vision is a possible antidepressant side effect in which a person becomes unable to see clearly.  In addition to a lack of sharpness in their vision, they may also experience such symptoms as burning, itching, redness of the eye, or scratchy or gritty sensations.

Blurred vision is most commonly associated with tricyclic antidepressants.   These antidepressants block the receptors for the neurotransmitter acetylcholine.

  When this receptor is blocked, tear production stops, causing the eyes to become dry (dry eye syndrome).  Because there are acetylcholine receptors in other areas of the body as well, this blockage can also lead to symptoms in other parts of the body, such as dry mouth and constipation.  

Blurred vision doesn't tend to be  a problem for long, however.  It usually subsides within a few weeks after treatment is initiated.

Helpful steps that you can take if you are experiencing blurred vision include:

  • Getting an eye exam to rule out other causes of blurred vision.
  • Using artificial tears during the day and lubricating ointment at bedtime to relieve the dryness.
  • Using a humidifier.
  • Avoiding smoking.
  • Talking with your doctor about punctal plugs.
  • Talking with your doctor about changing your dose.

If you continue to have problems with blurred vision, another option may be to talk with your doctor about changing to a different type of medication.

  Although tricyclics may be the best choice for some, other patients may do better with one of the newer medications types, such as the selective serotonin reuptake inhibitors (SSRIs) or the serotonin and norepinephrine reuptake inhibitors (SNRIs).  These antidepressants affect the acetylcholine receptors in a different way from the tricyclics and tend to have fewer side effects.

  Your doctor will be able to help you determine if using another type of medication is best for you.

If you are troubled by any side effects that you are experiencing, it is best to continue to take your medication as prescribed until you are advised by your doctor to make a change.   Stopping an antidepressant too quickly can lead to what is known as discontinuation syndrome, which can cause you to not feel well.  Symptoms of discontinuation syndrome can include muscle aches, nausea, fatigue, odd sensations and dizziness.  It is also possible that your depression could return or become worse if you stop taking your medication.  Your doctor will be able to advise you about how best to stop taking, or change, your medication in order to avoid these problems.

Sources:

Tu, Elmer Y. and Stephen Rheinstrom. "Chapter 65 - Dry Eye." Ophthalmology. Eds. Myron Yanoff et. al. 2nd ed. St. Louis: Mosby, Inc., 2004.

Warner, Christopher H. et. al. "Antidepressant Discontinuation Syndrome." American Family Physician 74.3 (2006): 449-56.

Wirbelauer, Christopher. "Management of the Red Eye for the Primary Care Physician." The American Journal of Medicine. 119.4 (2006): 302-6.

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