Does Sertraline affect glaucoma? (3+ precautions)

In this article, we will answer the question, ” Does Sertraline affect glaucoma?”. We will discuss some research studies in this regard, what precautions could be taken and what factors can influence the occurrence of glaucoma while on Sertraline.

Does Sertraline affect glaucoma?

Yes, Sertraline has the potential to affect the eye and cause or exacerbate glaucoma. Angle-closure glaucoma has been listed as a potential side effect by the FDA. Even though the incidence is low, however some individuals may experience this side effect (1).

Sertraline (also known as Zoloft) is an antidepressant belonging to the class of selective serotonin reuptake inhibitors (SSRIS) and is approved by the FDA for the treatment of various depressive illnesses. It has ben used off-label for many conditions as well (1,2).

Glaucoma is a group of eye diseases that affect the optic nerve and can result in vision problems and even blindness. Sertraline can exacerbate angle-closure glaucoma, a condition in which the intraocular pressure (IOP) increases.

The FDA has also issued warning that antidepressants like Sertraline should be used with precaution in individuals predisposed to angle-closure glaucoma.

How does Sertraline affect angle-closure glaucoma?

Antidepressants like SSRIs, including Sertraline are found to increase the risk of glaucoma in susceptible individuals. The mechanism through which this happens is found to be linked to IOP within the eye.

Sertraline and other SSRIs cause angle-closure glaucoma by directly affecting the IOP and causing it to rise significantly. Sertraline works by inhibiting serotonin reuptake, which is required to regulate the IOP (3).

Elevated serotonin leads to improper eye drainage. This can affect the amount of aqueous humour and increase the IOP. This increase in IOP can lead to, or exacerbate already present angle-closure glaucoma (3).

What does research suggest?

Various research studies, assessing the effect of Sertraline or SSRIs in general, have been published. Majority of the studies suggest that the use of antidepressants in the individuals at risk for glaucoma should be avoided. If the use of medication is absolutely necessary, it should be continuously monitored to avoid any side effects.

A research study assessing the effects of SSRIs on glaucoma reported that individuals receiving an antidepressant medication for a longer duration or at a higher dose was at a greater risk for the occurrence of glaucoma. The study suggested to use SSRIs for a shorter duration and long-term use to be avoided (3).

Another study examined the effects of Sertraline use on IOP and pupil dilation in individuals given the medication for three months. When compared with a control group, the individuals receiving Sertraline were found to have higher IOP even without any underlying eye problems (4).

A clinical study on the effects of SSRIs on acute angle-closure glaucoma reported that individuals when given SSRIs have a 5.8-fold higher risk of glaucoma. Sertraline was found to be the antidepressant with the second highest risk (5).

How to prevent Sertraline-induced glaucoma?

A few precautions that can be taken to prevent Sertraline-induced glaucoma are as follows:

Screening tests

To prevent Sertraline-induced angle-closure glaucoma, your healthcare provider will assess you for any risk factors that may lead to glaucoma while on Sertraline. Tests like gonioscopy, measuring IOP and optical coherence tomography of optic nerve head are recommended before initiation of treatment.

Regular follow-ups

IOP should be monitored regularly in individuals taking Sertraline whether or not they have the risk factors. Your doctor will schedule regular follow-up appointments to check for any problems.

Symptom monitoring

You should monitor your symptoms and if you feel anything unusual, you should immediately seek medical assistance. The symptoms of angle-closure glaucoma while on Sertraline can be as follows:

• Headache
• Nausea
• Vomiting
• Eye pain
• Eye redness
• Blurred vision
• Halos around lights

What factors influence glaucoma while on Sertraline?

The following factors may influence the occurrence of glaucoma while taking Sertraline:

How is Sertraline-induced glaucoma managed?

If you are taking Sertraline and experience ocular problems, you should contact your healthcare provider and communicate your concern. Your doctor will assess your situation and recommend an appropriate plan.

Your healthcare provider may decrease your dosage, or give you an alternative medication to help with your symptoms. You may also need medications for your ocular needs. Your doctor may prescribe one or more of the following medications, that may help your condition:

Understanding Sertraline-induced galucoma

To the best of my knowledge and according to available research, Sertraline may increase the risk of glaucoma. Some individuals may experience this side effect while others may not. Individuals with a history of glaucoma may be at a greater risk for an increased IOP and angle-closure glaucoma.

Sertraline-induced glaucoma can be prevented with the proper precautions and regular follow-ups. However, if you do experience any ocular problems while taking Sertraline, it is best to consult your healthcare provider for personalised guidance. 

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