Effetti oftalmologici indesiderati dei farmaci antidepressivi, ansiolitici e stabilizzatori del tono dell'umore

Of the various undesired side effects associated with antidepressants, minor tranquilizers and mood stabilizers commonly used in psychiatry, those affecting the eye and vision are often neglected and largely ignored. This review of published data calls the clinician's attention to the need for a better understanding of such adverse affects to ensure a correct, more rational pharmacotherapy with such agents, as the are also often employed in chronic treatment. Specifically, lesser known and not infrequently rare complications are examined, including mydriasis and tricyclic-antidepressant-induced cycloplegia, which may lead to the onset of acute glaucoma and augment the risk of irreversible severe eye damage, including blindness; the undesired effects of lithium salts are frequently a sign of neurotoxicity; the effects of carbamazepine and especially those caused by topyramate, an anticonvulsant increasingly used in psychiatry because of its therapeutic efficacy in the treatment of bipolar disorders and because of its ability to induce weight loss. The ocular side effects these agents cause may sometimes be so sever that compliance is reduced and health risks are increased. Close collaboration with the oculist and accurate monitoring of the patient's ophthalmic conditions are therefore recommended.