Antidepressants and risk of cataract development: A population-based, nested case-control study.
Previous studies demonstrated increased risk of cataract development among users of selective serotonin reuptake inhibitors (SSRIs). However, it remains unknown whether this risk also prevails with the use of other types of antidepressants. The aim of this study was to investigate whether use of antidepressants is associated with an increased risk of cataract development. Moreover, the relationship between binding affinities of serotonin transporter (SERT) of antidepressant and the risk of cataracts is examined.



We conducted a nested case-control study using National Health Insurance Research Database in Taiwan. A total of 14,288 patients were included; 7651 in the cataract group and 6637 in the control group. Antidepressant exposure was categorized by type, duration of use, and binding affinities of SERT. The association between antidepressant exposure and cataract development was assessed using conditional logistic regression analysis.



The adjusted odds ratios (AORs) for developing cataracts among continuous users of SSRIs, serotonin norepinephrine reuptake inhibitors (SNRIs), and other antidepressants were 1.26 (95% confidence interval (CI): 1.12-1.41, p<0.001), 1.21 (95% CI: 1.02-1.43, p=0.027), and 1.18 (95% CI: 1.04-1.34, p=0.009) respectively. Specifically, continuous uses of fluoxetine (AOR: 1.21; 95% CI: 1.01-1.46, p=0.042), fluvoxamine (AOR: 1.47; 95% CI: 1.01-2.12, p=0.043), venlafaxine (AOR: 1.44; 95% CI: 1.19-1.74, p<0.001) significantly increased the risk of cataract development. Moreover, continuous users of antidepressants with intermediate SERT binding affinities (AOR: 1.68; 95% CI: 1.10-2.56, p=0.017) were significantly associated with increased risks of cataract development.



Several confounding factors such as obesity, multiple drug users, family history of cataracts, substance use, and environmental factors (such as sunlight or radiation exposure) were acquired.



We found increased risk of cataract development in patients continuously using antidepressants. Regular ocular evaluations in these patients are warranted.
Department of Psychiatry, Taichung Veterans General hospital, Taichung, Taiwan; Department of Psychiatry, Faculty of Medicine, National Yang Ming University, Taipei, Taiwan; Department of Photonics, National Chiao Tung University, Hsinchu, Taiwan; Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan. Electronic address: phchou1980@gmail.com.
Po-Han
PH
Chou
Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
Che-Sheng
CS
Chu
Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan.
Yi-Huei
YH
Chen
Department of Ophthalmology, Taichung Veterans General Hospital, Taichung, Taiwan.
Min-Yen
MY
Hsu
Chia-Yi branch, Taichung Veterans General Hospital, Chiayi City, Taiwan.
Min-Wei
MW
Huang
Department of Psychiatry, Taichung Veterans General hospital, Taichung, Taiwan; Department of Psychiatry, Faculty of Medicine, National Yang Ming University, Taipei, Taiwan.
Tsuo-Hung
TH
Lan
Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan. Electronic address: lonelymanym@yahoo.com.tw.
Ching-Heng
CH
Lin
D018759:Adrenergic Uptake Inhibitors / Q000009:adverse effects; D000368:Aged; D000928:Antidepressive Agents / Q000009:adverse effects*; D016022:Case-Control Studies; D002386:Cataract / Q000139:chemically induced* / Q000453:epidemiology*; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000235:genetics; D008875:Middle Aged; D020641:Polymorphism, Single Nucleotide / Q000235:genetics; D018570:Risk Assessment; D050486:Serotonin Plasma Membrane Transport Proteins / Q000235:genetics / Q000378:metabolism; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects; D013624:Taiwan / Q000453:epidemiology
D018759:Adrenergic Uptake Inhibitors; D000928:Antidepressive Agents; D050486:Serotonin Plasma Membrane Transport Proteins; D017367:Selective Serotonin Reuptake Inhibitors; C493230:SLC6A4 protein, human
Antidepressants; Cataract; Selective serotonin reuptake inhibitor; Serotonin norepinephrine reuptake inhibitors