Medications Used for ADHD Associated with Higher Glaucoma Risk

A recent study conducted in Canada has unveiled a concerning link between commonly prescribed drugs for attention-deficit/hyperactivity disorder (ADHD) and an elevated risk of glaucoma.

Glaucoma, a progressive eye condition leading to vision loss, poses a particular concern when considering certain ADHD medications, especially those associated with angle-closure glaucoma (ACG).

Dr. Rami Darwich, the lead author of the study and an ophthalmology resident, emphasized that while the study doesn’t establish causation, it underscores the heightened risk of glaucoma associated with these medications.

ADHD medications predominantly fall into two categories: sympathomimetic drugs and non-sympathomimetic drugs. Sympathomimetic drugs, like methylphenidate and amphetamines, stimulate the sympathetic nervous system to aid concentration, albeit potentially contributing to elevated eye pressure. On the other hand, non-sympathomimetic drugs, such as atomoxetine, augment brain chemicals to enhance focus and concentration.

The study, encompassing 240,257 newly prescribed individuals, monitored the use of methylphenidate, amphetamines, atomoxetine, or a combination thereof over a year or more. It compared these subjects with non-users to ascertain glaucoma risks.

Results indicated that individuals taking amphetamines and atomoxetine faced a higher risk of ACG, while those prescribed methylphenidate showed an elevated risk of open-angle glaucoma (OAG).

ACG manifests when the drainage system within the eye is abruptly blocked, causing a sudden rise in eye pressure, leading to symptoms like severe eye pain and blurred vision. Conversely, OAG, characterized by a slower drainage process, often progresses silently, with symptoms appearing only when significant damage has occurred.

Despite methylphenidate’s link to OAG, the study found it less associated with ACG compared to other ADHD medications.

The sympathetic nervous system activation induced by these medications, resulting in pupil dilation, could obstruct the eye’s drainage pathway, thus elevating eye pressure and damaging optic nerves, precipitating glaucoma.

Further studies are warranted to validate these findings and delve into the intricate relationship between ADHD medication use and glaucoma, particularly given the widespread use of these medications both medically and recreationally.

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