According to a recent study by resident physician Dr. Rami Darwich, common medications for ADHD are linked to an increased risk of glaucoma. This includes amphetamines and methylphenidate, which may elevate intraocular pressure and potentially lead to vision loss.
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A recent Canadian study discovered that common medications used to treat attention-deficit/hyperactivity disorder (ADHD) are linked to an increased risk of glaucoma.
Vision loss is a result of the degenerative eye illness glaucoma. There is a subtype of angle-closure glaucoma that is contraindicated with common ADHD medications.
The study’s principal author, resident physician Dr. Rami Darwich, stated to The Epoch Times that the research “does not establish causation but rather highlights an elevated risk of glaucoma.”
Common ADHD Drugs
Numerous widely used medications for ADHD are sympathomimetic, which means that they aid in attention by stimulating the sympathetic nervous system. However, their aftereffects may unintentionally lead to increased intraocular pressure.
Although Dr. Darwich noted that certain cases of glaucoma have recently developed even in the absence of notable pressure increases, high eye pressure is still a major risk factor for the disease.
Sympathetic stimulants like amphetamines and methylphenidate are common ADHD medications. Because of their higher efficacy, these are frequently the first-choice therapies for individuals with ADHD. About 70% of ADHD patients find relief using psychostimulants.
Drugs that are not sympathomimetic, like atomoxetine, stimulate certain chemicals in the brain to aid in mental function and focus. Usually, atomoxetine is recommended when a patient does not respond to first-line medications.
For a year or longer, the study’s authors monitored 240,257 newly prescribed patients who used atomoxetine, amphetamines, methylphenidate, or a combination of these medications.
After taking ADHD medications, study participants were followed up with and their glaucoma risk was compared to that of non-users.
Individuals using atomoxetine and amphetamines were more likely to develop angle-closure glaucoma (ACG), but methylphenidate users were more likely to develop open-angle glaucoma (OAG).
The fluids that make up our eyes. Dr. Darwich described ACG as happening when “the drainage pipe of the sink gets blocked, causing the water (fluid inside your eye) to build up suddenly,” likening it to a sink.
“The drainage pipe is open, but it feels narrow or clogged, so the water (fluid inside your eye) drains too slowly,” he explained in reference to OAG.
One might experience “severe eye pain, headache, and blurred vision” with ACG. “It can feel like there’s pressure building up in your eye.”
OAG is more chronic and initially exhibits no symptoms at all. Blind spots might start on the periphery of one’s eyesight and eventually move to the center. But by then, a lot of the damage to the eyes has already occurred.
A mild association between atomoxetine and amphetamine use and the onset of OAG was also seen by the authors, but one that was not statistically significant.
How ADHD Drugs Contribute to Glaucoma
The lack of a clear correlation between methylphenidate and ACG, which is contraindicated by psychostimulants that activate the neurological system, astonished the authors.
Methylphenidate and amphetamines are examples of sympathomimetic medications that are generally not advised for people with confirmed or suspected ACG.
The pupils enlarge as a result of these drugs’ activation of the sympathetic nervous system, which primes the body for fight or flight. This might mechanically impede the eye’s normal drainage channel. This accumulation of fluid can lead to progressive vision loss and glaucoma by damaging the optic nerves and raising intraocular pressure.
OAG is more prevalent than ACG, although it has a lower risk of vision loss and there is less proof linking it to ADHD medications.
The medication methylphenidate, which has been linked to an increased risk of OAG, has also been demonstrated to be harmful to eye cells. The three drugs under investigation have also been shown to cause redox reactions, which can result in oxidative damage and damage to optical nerves, thereby compromising eye health.
Individuals who do not metabolize ADHD medications well may also be more susceptible to drug-induced glaucoma.
“Given the prevalence of ADHD medication use (medically and recreationally), further studies are needed to confirm our findings and investigate associations of ADHD medication use and glaucoma,” the authors wrote.
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