Antidepressants glaucoma with

The miscellaneous anticonvulsants are used cautiously in patients with glaucoma or increased intraocular pressure a history of cardiac, renal or liver dysfunction and psychiatric disorders. When the miscellaneous anticonvulsants are used with other CNS depressants (eg, alcohol, narcotic analgesics, and antidepressants), an additive CNS depressant effect may occur. 

Acetylcholine-blocking drugs should be avoided in patients with prostatic hyperplasia, obstructive gastrointestinal disease (eg, pyloric stenosis or paralytic ileus), or angle-closure glaucoma. In parkinsonism patients receiving antimuscarinic medication, concomitant administration of other drugs with antimuscarinic properties (eg, tricyclic antidepressants or antihistamines) may precipitate some of the complications mentioned above. 

Loss of accommodation and blurred vision are common inconveniences that can usually be tolerated, in the knowledge that they lessen with the duration of treatment. Exacerbation of narrow-angle glaucoma in the elderly can occur, but is not an absolute contraindication to treatment with a tricyclic antidepressant, since the anticholinergic effects can be balanced by judicious use of pilocarpine (73,74). 

Tricyclic antidepressants predispose to acute angle closure glaucoma, probably through an anticholinergic action. However, acute angle closure has also been reported with SSRIs, suggesting that all serotonin-... 

What other medical conditions does the patient have Choosing an antidepressant for a healthy young adult may lead to a different choice than an antidepressant for a man in his 60s with diabetes, hypertension, glaucoma, and prostatism. Some psychotropic medications can make the symptoms of other medical conditions worse. 

Cyclobenzaprine (10 mg t.i.d.) is a centrally acting skeletal muscle relaxant and is indicated as an adjunct to rest and physical therapy for relief of muscular spasm associated with injury related to painful musculoskeletal conditions. However, cyclobenzaprine is not effective in spasticity associated with cerebral or spinal cord injury. Cyclobenzaprine is structurally related to tricyclic antidepressants possessing sedative and anticholinergic properties. Therefore, cyclobenzaprine should be used cautiously in individuals with angle-closure glaucoma and urinary retention due to obstruction or prostatic hypertrophy. Because it causes drowsiness and blurred vision, it should be used carefully when alermess is required. 

Similar caution should be exercised with biogenic amine uptake blockers such as tricyclic antidepressants. Amphetamine is contraindicated in advanced arteriosclerosis symptomatic cardiovascular disease moderate to severe hypertension hyperthyroidism hypersensitivity or idiosyncrasy to the sympathomimetic amines glaucoma agitated states history of drug abuse and during or within 14 days following administration of monoamine oxidase (MAO) inhibitors. 

Xylometazoline is contraindicated in patients with narrow-angle glaucoma, because the drug may increase intraocular pressure, and in patients receiving tricyclic antidepressants, because of the potential for adverse cardiovascular effects. 

ADVERSE EEEECTS Tricyclic antidepressants routinely produce adverse autonomic responses, in part related to their relatively potent antimuscarinic effects, including dry mouth and a sour or metallic taste, epigastric distress, constipation, dizziness, tachycardia, palpitations, blurred vision (poor accommodation and increased risk of glaucoma), and urinary retention. Cardiovascular effects include orthostatic hypotension, sinus tachycardia, and variable prolongation of cardiac conduction times with the potential for arrhythmias, particularly with overdoses. 

Relative history of seizure disorder, bipolar disorder (may induce mania), urinary retention, narrow-angle glaucoma, delirium, hyperthyroidism, bradycardia (or drugs that cause bradycardia), or electrolyte disturbance (esp. K+ or Mg ). Use caution in conjunction with other antidepressants (including MAOIs and SSRIs), other anticholinergic medications, drugs that increase plasma levels (phenothiazines, haloperidol, cimetidine), or drugs that lower seizure threshold (esp. tramadol). Use caution in elderly, children/adolescents. 

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