Desvenlafaxine induced acute angle-closure glaucoma - Case report

Authors

venkatesh babu Dr, JSS MEDICAL COLLEGE AND HOSPITALFollow
Priyankha Kothandaraman Dr, JSS MEDICAL COLLEGE AND HOSPITALFollow
Megha Sadashiv Dr., JSS MEDICAL COLLEGE AND HOSPITALFollow
Kishor M, JSS Medical College and Hospital, MysuruFollow

Author ORCID Identifier

https://orcid.org/0009-0002-2671-459X

Corresponding Author

Dr Venkatesh Babu

mayakuntlavenkatesh@gmail.com

Abstract

The World Health Organization (WHO) estimates that Depressive disorder affects more than 264 million people worldwide. The global prevalence of depression among those who are aged 18 years and older was approximately 4.4%. According to a 2017 study by India's National Institute of Mental Health and Neuroscience s (NIMHANS), 7.5% of the population in the nation suffers from depression affecting one in 20 Indians_[1].

SSRIs ( Selective Serotonin Re uptake Inhibitors) and SNRIs ( serotonin-nor epinephrine re uptake inhibitors) are increasingly the first-line choices of anti-depressant because of their tolerable side-effect profile and low rate of lethality if taken in an overdose. Desvenlafaxine is a specific inhibitor of serotonin-nor epinephrine re uptake (SNRI) which desensitizes the feedback systems that regulate the rate-limiting enzyme in 5-HT(5-hydroxytryptamine) production resulting in an increase in the levels of serotonin (5-HT) in the post-synaptic region. Human eyes have been found to contain serotonin (5-HT) receptors. Also, it has been noted that compared to non-mammalian species, mammalian ciliary bodies and corneas have a larger concentration of serotonin (5-HT) receptors_[2].

Glaucoma is defined as a heterogeneous group of diseases that have in common a characteristic optic neuropathy and visual defects, for which elevated IOP is the primary risk factor. It affects 76 million people globally_[3]. Due to the uncertainty surrounding the incidence of glaucoma caused by local or systemic therapy, these numbers may not include drug- induced glaucoma cases. Acute angle-closure glaucoma affects 10 out of every 100,000 people. The narrow angle of the anterior chamber, shallow depth of the anterior chamber, hyperopia, tiny eyes, positive family history of angle closure, ageing, female sex, usage of drugs that produce papillary dilatation, and stressful events are risk factors for angle-closure glaucoma. Several medication classes, including adrenergic agonists, cholinergic, anticholinergics, sulpha-based medicines, selective serotonin re uptake inhibitors, tricyclic and tetracyclic antidepressants, anticoagulants, and H1 and H2 receptor antagonists, can induce or worsen angle-closure glaucoma. Even though anti-cholinergic side effects or elevated serotonin levels, which produce partial papillary dilatation, have been suggested, the pathophysiological mechanism of SNRI-induced acute angle-closure glaucoma is still unknown_[4].

Publication Date

Summer 5-16-2024

Publisher

JSS Academy of Higher Education & Research

Conflict of Interest

NONE

Keywords

Desvenlafaxine, glaucoma, acute angle-closure glaucoma

Word Count

1157

Recommended Citation

babu v Dr, Kothandaraman P Dr, Sadashiv M Dr., M K. Desvenlafaxine induced acute angle-closure glaucoma - Case report. Digital Journal of Clinical Medicine. 2024; 6(3): -. doi: https://doi.org/10.55691/2582-3868.1188

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