{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:32:37Z","timestamp":1786649557675,"version":"build-2736575974"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"Suppl 3","license":[{"start":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T00:00:00Z","timestamp":1748563200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>The purpose of this study was to compare the effect of sympathomimetic or anticholinergic psychotropic drugs (tricyclic antidepressants, selective serotonin reuptake inhibitors, and benzodiazepines (TCADs, SSRIs, and BZDs)) with that of non-sympathomimetic\/anticholinergic drugs (lithium) on intraocular pressure (IOP) and angle parameters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>The study was conducted at a tertiary health care center in South India from December 2023 to February 2024. Seventy-two stable patients (&gt;18 years) on long-term psychotropic therapy (&gt;6 months duration) were recruited by consecutive sampling from the psychiatry department follow-up clinic and divided into two groups: Group 1 (TCADs, SSRIs, and BZDs) \u2013 50 patients; Group 2 (lithium) \u2013 22 patients. The primary outcome was differences in the two groups for IOP, angle appearance by gonioscopy, and angle measurements with anterior-segment optical coherence tomography (Cirrus HD-OCT) by masked observers in only one eye of each participant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      There was no significant difference in IOP between the two groups. A significantly greater proportion of patients in the group on TCADs, SSRIs, and BZDs had narrower angles than the lithium group (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.045) on gonioscopy. On AS-OCT, the mean scleral spur angle in Group 1 patients was 28.38\u00b0 \u00b1 7.62\u00b0 and in Group 2 was 36.23\u00b0 \u00b1 8.08\u00b0 (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). The angle opening distance 500 (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.001) and trabecular iris space area (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.003) were also significantly lower in Group 1.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Our study shows that patients on psychotropic drugs (TCADs, SSRI, and BZDs) with sympathetic\/cholinomimetic effects have narrower angles than those on lithium and may be at risk of developing angle closure glaucoma.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijo.ijo_2804_24","type":"journal-article","created":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T05:00:15Z","timestamp":1748581215000},"page":"S454-S459","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":4,"title":["Comparing the effect of sympathomimetic\/anticholinergic psychotropic drugs with that of non-sympathomimetic\/anticholinergic psychotropic drugs on IOP and angle parameters among patients on long-term therapy"],"prefix":"10.4103","volume":"73","author":[{"given":"Geeta","family":"Behera","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Jawaharlal Institute of Post-Graduate Medical Education and Research (JIPMER), Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jayarani","family":"Lenin","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Jawaharlal Institute of Post-Graduate Medical Education and Research (JIPMER), Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Balaji","family":"Bharadwaj","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Jawaharlal Institute of Post-Graduate Medical Education and Research (JIPMER), Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karthikeyan","family":"Mahalingam","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Jawaharlal Institute of Post-Graduate Medical Education and Research (JIPMER), Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anusuya","family":"Ram","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Jawaharlal Institute of Post-Graduate Medical Education and Research (JIPMER), Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaviyapriya","family":"Natarajan","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Jawaharlal Institute of Post-Graduate Medical Education and Research (JIPMER), Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharmi","family":"Bascarane","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Jawaharlal Institute of Post-Graduate Medical Education and Research (JIPMER), Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Subashini","family":"Kaliaperumal","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Jawaharlal Institute of Post-Graduate Medical Education and Research (JIPMER), Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kanchan","family":"Dolli","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Jawaharlal Institute of Post-Graduate Medical Education and Research (JIPMER), Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,5,30]]},"reference":[{"key":"R2-20260422","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1111\/aos.12784","article-title":"Primary angle-closure glaucoma: An update","volume":"94","author":"Wright","year":"2016","journal-title":"Acta Ophthalmol"},{"key":"R3-20260422","doi-asserted-by":"crossref","first-page":"2947.","DOI":"10.3390\/jcm10132947","article-title":"Psychopharmacological treatment, intraocular pressure and the risk of glaucoma: A review of literature","volume":"10","author":"Ciobanu","year":"2021","journal-title":"J Clin Med"},{"key":"R4-20260422","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1038\/s41433-019-0603-z","article-title":"A review of systemic medications that may modulate the risk of glaucoma","volume":"34","author":"Wu","year":"2020","journal-title":"Eye (Lond)"},{"key":"R5-20260422","doi-asserted-by":"crossref","first-page":"6.","DOI":"10.5339\/qmj.2015.6","article-title":"A review of drug-induced acute angle closure glaucoma for non-ophthalmologists","volume":"2015","author":"Ah-Kee","year":"2015","journal-title":"Qatar Med J"},{"key":"R6-20260422","doi-asserted-by":"crossref","first-page":"e0173005.","DOI":"10.1371\/journal.pone.0173005","article-title":"Effects of selective serotonin reuptake inhibitors on glaucoma: A nationwide population-based study","volume":"12","author":"Chen","year":"2017","journal-title":"PLoS One"},{"key":"R7-20260422","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1089\/jop.2017.0133","article-title":"How does usage of serotonin noradrenaline reuptake inhibitors affect intraocular pressure in depression patients?","volume":"34","author":"U\u00e7an G\u00fcnd\u00fcz","year":"2018","journal-title":"J Ocul Pharmacol Ther"},{"key":"R8-20260422","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1097\/JCP.0b013e31825420a1","article-title":"Short-term exposure to antidepressant drugs and risk of acute angle-closure glaucoma among older adults","volume":"32","author":"Seitz","year":"2012","journal-title":"J Clin Psychopharmacol"},{"key":"R9-20260422","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/j.jad.2018.07.079","article-title":"The risk of glaucoma and serotonergic antidepressants: A systematic review and meta-analysis","volume":"241","author":"Wang","year":"2018","journal-title":"J Affect Disord"},{"key":"R10-20260422","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1007\/s40264-020-00914-7","article-title":"Benzodiazepine use and risk of acute angle-closure glaucoma: A population-based case-crossover study","volume":"43","author":"Kim","year":"2020","journal-title":"Drug Saf"},{"key":"R11-20260422","doi-asserted-by":"crossref","first-page":"e692","DOI":"10.4088\/JCP.15m10038","article-title":"Association of selective serotonin reuptake inhibitor use and acute angle-closure glaucoma","volume":"77","author":"Chen","year":"2016","journal-title":"J Clin Psychiatry"},{"key":"R12-20260422","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jpsychores.2019.04.013","article-title":"Association between use of benzodiazepines and occurrence of acute angle-closure glaucoma in the elderly: A population-based study","volume":"122","author":"Park","year":"2019","journal-title":"J Psychosom Res"},{"key":"R13-20260422","doi-asserted-by":"crossref","first-page":"1308","DOI":"10.1016\/j.ajo.2013.07.027","article-title":"Six-year incidence of angle-closure disease in a South Indian population: The Chennai eye disease incidence study","volume":"156","author":"Vijaya","year":"2013","journal-title":"Am J Ophthalmol"},{"key":"R14-20260422","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1016\/S2215-0366(19)30475-4","article-title":"The burden of mental disorders across the states of India: The Global Burden of Disease Study 1990- 2017","volume":"7","year":"2020","journal-title":"Lancet Psychiatry"},{"key":"R15-20260422","doi-asserted-by":"crossref","first-page":"573150.","DOI":"10.3389\/fpsyt.2020.573150","article-title":"Prevalence of common mental disorders in South Asia: A systematic review and meta-regression analysis","volume":"11","author":"Naveed","year":"2020","journal-title":"Front Psychiatry"},{"key":"R16-20260422","doi-asserted-by":"crossref","first-page":"473.","DOI":"10.3390\/biomedicines9050473","article-title":"Lithium and atypical antipsychotics: The possible WNT\/\u03b2 pathway target in glaucoma","volume":"9","author":"Vall\u00e9e","year":"2021","journal-title":"Biomedicines"},{"key":"R17-20260422","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1016\/j.neulet.2013.08.057","article-title":"RNAi screening identifies GSK3\u03b2 as a regulator of DRP1 and the neuroprotection of lithium chloride against elevated pressure involved in downregulation of DRP1","volume":"554","author":"Wu","year":"2013","journal-title":"Neurosci Lett"},{"key":"R18-20260422","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1111\/j.1755-3768.1985.tb06815.x","article-title":"Ocular effects of oral lithium in humans","volume":"63","author":"Kaufman","year":"1985","journal-title":"Acta Ophthalmol (Copenh)"},{"key":"R19-20260422","doi-asserted-by":"crossref","first-page":"475","DOI":"10.2165\/00023210-200418080-00001","article-title":"SSRIs and intraocular pressure modifications: Evidence, therapeutic implications and possible mechanisms","volume":"18","author":"Costagliola","year":"2004","journal-title":"CNS Drugs"},{"key":"R20-20260422","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1016\/j.survophthal.2018.09.006","article-title":"Association between serotonin-norepinephrine reuptake inhibitors and acute angle closure: What is known?","volume":"64","author":"Wici\u0144ski","year":"2019","journal-title":"Surv Ophthalmol"},{"key":"R21-20260422","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1001\/archopht.1994.01090130077021","article-title":"Oral imipramine and acute angle closure glaucoma","volume":"112","author":"Ritch","year":"1994","journal-title":"Arch Ophthalmol"},{"key":"R22-20260422","first-page":"668","article-title":"Glaucoma","volume":"93","author":"Gupta","year":"2016","journal-title":"Am Fam Physician"},{"key":"R23-20260422","doi-asserted-by":"crossref","first-page":"351","DOI":"10.24869\/psyd.2017.351","article-title":"Glaucoma, depression and quality of life: Multiple comorbidities, multiple assessments and multidisciplinary plan treatment","volume":"29","author":"Pel\u010di\u0107","year":"2017","journal-title":"Psychiatr Danub"},{"key":"R24-20260422","doi-asserted-by":"crossref","first-page":"11671.","DOI":"10.1038\/s41598-018-29489-1","article-title":"Illness uncertainty, anxiety and depression in Chinese patients with glaucoma or cataract","volume":"8","author":"Zhang","year":"2018","journal-title":"Sci Rep"},{"key":"R25-20260422","first-page":"41","article-title":"Associating factors of insomnia and depression in glaucoma: A descriptive analysis","volume":"4","author":"Akhilesh","year":"2018","journal-title":"Int Multispec J Health IMJH"}],"container-title":["Indian Journal of Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/IJO.IJO_2804_24","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T18:55:20Z","timestamp":1786647320000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/IJO.IJO_2804_24"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,30]]},"references-count":24,"journal-issue":{"issue":"Suppl 3","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/ijo.ijo_2804_24","relation":{},"ISSN":["0301-4738","1998-3689"],"issn-type":[{"value":"0301-4738","type":"print"},{"value":"1998-3689","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,30]]},"assertion":[{"value":"2024-11-24","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-13","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}