Does Trazodone cause glaucoma? (+3 factors)

In this article, we will discuss whether Trazodone can cause glaucoma. We will also discuss some research studies and what one should do if this side effect occurs.

Does Trazodone cause glaucoma?

Yes, Trazodone can cause glaucoma in some individuals. Although it is a listed side effect, the incidence is low.

Trazodone is an antidepressant which works by blocking the reuptake of serotonin and increasing its concentration in the brain (1). Like many other pharmaceuticals, Trazodone is linked to various side effects, including its serotonergic and mild anticholinergic effects.

Trazodone-induced anticholinergic and serotonergic effects can potentially contribute to glaucoma in some patients, making it contraindicated for individuals with pre-existing glaucoma.

Trazodone can sometimes cause mydriasis, resulting in the development of angle-closure glaucoma (4). It is essential to recognise that while not everyone who takes this medication will experience this side effect, caution is advised when using Trazodone if you have a history of glaucoma.

Why does Trazodone cause glaucoma?

Trazodone causes glaucoma by increasing intraocular pressure (IOP) in some people. Trazodone inhibits serotonin reuptake and cholinergic receptors, along with causing mydriasis. It results in elevated intraocular pressure in some individuals, resulting in the development of glaucoma.

IOP usually depends on the amount of aqueous humour in the anterior chamber of the eye. Elevated serotonin levels can affect the eye drainage angle, potentially leading to increased intraocular pressure and contributing to the development of glaucoma.

What does research suggest?

There are limited research studies indicating the relationship between Trazodone and glaucoma. One study found that an increase in intraocular pressure was seen in young people using Trazodone (2).

Finding it early and getting it right is crucial because it could lead to eye problems like acute angle-closure glaucoma or fluid build-up. The only solution here is to stop the medication to fix the problem (2).

Another study also indicated the link between the use of low doses of Trazodone with making angle-closure glaucoma worse (3).

If you experience glaucoma while using antidepressants like Trazodone, Citalopram, Pristiq etc, reach out to your healthcare provider for proper guidance.

What factors influence glaucoma while using Trazodone?

The following factors can influence glaucoma while taking Trazodone. These include:

Individual sensitivity

Every individual is unique and has a unique genetic makeup, so their responses to medications are also different, especially when it comes to medications that affect brain chemistry.

This is the reason some people experience glaucoma while using Trazodone and others do not.

Underlying medical condition

Sometimes pre-existing eye conditions such as a history of glaucoma or a narrow iridocorneal angle (drainage angle between the iris and the cornea) can affect how the eye responds to the medication.

It is important to inform your healthcare provider about your pre-existing health condition to ensure the safe use of Trazodone.

Drug interactions

Some medications when taken with Trazodone can cause glaucoma. Although Trazodone does not directly affect eye pressure, certain medications when taken concurrently, could impact intraocular pressure.

It is important to inform your doctor about all medications and supplements you are taking to reduce the potential side effects.

Dosage and duration

The dosage of the medication also impacts its effectiveness. People responding well to the lower doses may experience increased side effects after the dose escalation such as glaucoma or increased IOP.

Long duration of medication use may also make individuals more prone to experiencing side effects including intraocular pressure (IOP).

It is essential to consult with a healthcare professional or an eye specialist if you have concerns about changes in your eye pressure or eye-related symptoms while using Trazodone. They can provide personalized guidance, and if needed, perform specific eye examinations to evaluate and address any issue.

How is Trazodone-induced glaucoma managed in a clinical setting? 

The primary goal of managing Trazodone-induced glaucoma in a clinical setting is to decrease intraocular pressure, which can be achieved through the following approaches (5):

• Mitotic medications (pilocarpine) and anticholinesterase (physostigmine) are useful in constricting the pupil and managing the angle of glaucoma.
• Beta-blockers (timolol) may be useful in reducing aqueous humour production and intraocular pressure.
• Carbonic anhydrases (acetazolamide) are useful in decreasing aqueous humour and IOP.

If you suspect that Trazodone is causing glaucoma, reach out to your healthcare provider. They can evaluate the symptoms in the context of the individual’s overall health and medication regimen.

Your healthcare provider might adjust your dosage of Trazodone, switch to a different medication, or recommend additional tests to rule out the cause.

External factors such as stress, fatigue, or caffeine consumption can also cause glaucoma. Keeping an eye on daily activities, food and beverage intake and stress level can provide insights into whether IOP correlates with specific triggers.

Antidepressants like Trazodone have withdrawal symptoms when discontinued abruptly (6). If someone wants to stop or believes that medication is causing side effects, it is important to reach out to your healthcare provider. They can provide a tapering schedule to minimize potential withdrawal or side effects.

What are the alternatives to Trazodone if it causes glaucoma?

If you are experiencing glaucoma while taking Trazodone, it is crucial to discuss this with your healthcare provider. they can suggest some alternative medications that don’t pose risk to your eye health. These include:

Selective serotonin reuptake inhibitors

• Sertraline
• Fluoxetine
• Citalopram

Serotonin-norepinephrine reuptake inhibitors

• Venlafaxine
• Duloxetine
• Desvenlafaxine

These medications can help with depression and anxiety without the same impact on glaucoma.

Benzodiazepines

• Temazepam
• Lorazepam

These medications can help with short-term insomnia but should be used cautiously due to their potential for dependence.

In my view and the knowledge available, Trazodone can cause glaucoma in some individuals. However, responses can vary from person to person. If you experience glaucoma while taking Trazodone, it is crucial to discuss it with your healthcare provider for personalized guidance and treatment plans.

Additionally, closely monitoring your treatment while taking this medication is important in order to minimise the risk of ocular side effects, including glaucoma. 

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