Can Trazodone cause dry eyes? (3+mechanisms)

In this article, we will address the question: Can Trazodone cause dry eyes? We will explore the mechanisms behind this side effect, discuss potential factors contributing to Trazodone-induced dry eyes, and potential treatments.

Can Trazodone cause dry eyes?

Yes, Trazodone can cause dry eyes in some individuals. This is a commonly reported side effect of antidepressant medications like Trazodone.

Trazodone-induced dry eyes normally present with symptoms of a burning, gritty sensation and blurry vision of the eyes (1). These symptoms are especially common in people who are new to Trazodone. This could happen because of how Trazodone affects some physiological functions.

However, the intensity of this side effect reduces as your body adjusts to the medication.

What does research suggest?

Trazodone is a Serotonin Antagonist and Reuptake Inhibitor that is used in the management of depressive disorders. This medication is known to have effects on adrenergic receptors, serotonergic receptors, and histamine receptors. It also has minimal effects on cholinergic receptors (2).

Although there is limited research on the mechanism by which Trazodone causes dry eyes, several research studies have suggested the following mechanisms:

Anticholinergic effects: Trazodone has minimal anticholinergic properties that can interfere with the nervous function that regulates tear production (3). Trazodone’s anticholinergic effect reduces the stimulation of tear glands causing decreased tear production and dry eyes.

Additionally, Trazodone’s anticholinergic effect decreases conjunctival mucus production thereby decreasing eye moisture and causing dry eyes (3).

Adrenergic effects: Trazodone’s adrenergic effects cause a change in tear volume and quality potentially causing dry eyes (4).

Serotonergic effects: Trazodone’s primary mechanism involves an increase in serotonin levels. Upregulation of serotonin in the tear film induces inflammatory reactions affecting ocular surface integrity and causing dry eyes (6).

Reduced blinking while sleeping: This mechanism is related to sleep patterns and not the chemical components of the medication. As a sleep aid, Trazodone causes reduced blinking which causes insufficient spread of tears on the eye’s surface contributing to dry eyes upon waking up (4,5,6).

What factors can contribute to Trazodone-induced dry eyes?

It is important to note that not everyone who takes Trazodone will experience dry eyes. Some people may be more susceptible due to their unique physiology and other factors such as:(4,5)

  • Medication dosage- Higher trazodone doses are likely to increase the risk of Trazodone-induced dry eyes
  • Duration of Trazodone – Prolonged use of the medication is also associated with dry eyes
  • Concurrent medications- Using Trazodone with other medications that have anticholinergic properties increases the risk of this side effect
  • Underlying Ocular conditions- Pre-existing conditions could make individuals susceptible to dry eyes or worsen dry eyes
  • Environmental factors- Low humidity, exposure to allergens and heating systems may worsen dry eye symptoms.
  • Age- Tear production naturally decreases with age predisposing older individuals to dry eye symptoms
  • Reduced blinking may also contribute to dry eyes

What to do if you experience Trazodone-induced dry eyes?

If you are experiencing dry eyes while taking Trazodone, it is important to consult your healthcare provider. Discussing your symptoms with your doctor is important to determine whether the causative agent is Trazodone.

If your symptom is caused by Trazodone, your doctor may adjust your treatment by modifying your dosage or prescribing an alternative medication with fewer side effects. However, make sure you do not stop taking Trazodone abruptly. This medication requires gradual dose tapering before you stop using it altogether.

Using artificial tears can help alleviate dry eye symptoms by supplementing the eyes’ natural tear film. This helps to reduce dryness and discomfort.

Staying well-hydrated is also useful in managing dry eyes. you should drink plenty of water to support tear production.

Although it may seem silly, it is also important to blink regularly to promote tear spread on the eye surface.

Conclusion:

Trazodone-induced dry eyes can be a very uncomfortable side effect. Understanding the potential mechanisms and factors precipitating this side effect is important in determining the management strategies you can use to alleviate symptoms.

Frequent consultation with your doctor while on this medication will provide you with personalized guidance on how to best manage this symptom.

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References

1.-

Constable PA, Al-Dasooqi D, Bruce R, Prem-Senthil M. A Review of Ocular Complications Associated with Medications Used for Anxiety, Depression, and Stress. Clinical Optometry [Internet]. 2022 Feb 24;14:13–25. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8884704/

 

2.-

Shin JJ, Saadabadi A. Trazodone [Internet]. PubMed. Treasure Island (FL): StatPearls Publishing; 2020. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470560/

 

3.-

Gershon S, Newton R. Lack of anticholinergic side effects with a new antidepressent–trazodone. The Journal of Clinical Psychiatry [Internet]. 1980 Mar 1 [cited 2023 Sep 17];41(3):100–4. Available from: https://pubmed.ncbi.nlm.nih.gov/7354015/

 

4.-

Fraunfelder FT, Sciubba JJ, Mathers WD. The Role of Medications in Causing Dry Eye [Internet]. Journal of Ophthalmology. 2012. Available from: https://www.hindawi.com/journals/joph/2012/285851/

 

5.-

Miguel A, Henriques F, Azevedo LF, Pereira AC. Ophthalmic adverse drug reactions to systemic drugs: a systematic review. Pharmacoepidemiology and Drug Safety. 2014 Jan 27;23(3):221–33.

 

6.-

Fagiolini A, Comandini A, Dell’Osso MC, Kasper S. Rediscovering Trazodone for the Treatment of Major Depressive Disorder. CNS Drugs [Internet]. 2012 Dec 1;26(12):1033–49. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3693429/

 

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