Antidepressants can provide much-needed support for individuals struggling with depression and anxiety. These medications work by altering the levels of certain chemicals in the brain to improve mood and reduce symptoms associated with mental health conditions. However, antidepressants can have potential side effects, including dry eyes. 

If you experience dry eyes while taking antidepressants, speak to an eye doctor about your concerns. Through open communication with your eye doctor and other healthcare providers, you can find relief from dry eyes while continuing to benefit from necessary medications.

What Are Antidepressants?

Antidepressants alter chemical levels in the brain by increasing the release of neurotransmitters like serotonin, dopamine, and norepinephrine. These chemicals may lessen the symptoms of depression and anxiety, and help provide relief to individuals who often feel overwhelmed by their emotional struggles.

What Is Dry Eye Disease?

Dry eye disease occurs when the eyes fail to produce enough tears or when the quality of tears is compromised, meaning the tears lack 1 or more layers, including aqueous (water), oil, or mucous. Dry eye symptoms can include:

• Irritation
• Redness
• Burning or stinging
• Blurry vision
• A gritty sensation

People over 50 are more at risk for dry eyes. There are several causes of dry eye disease, including:

• Age
• Gender
• Health conditions
• Laser eye surgery
• Prolonged screen use
• Environmental factors
• Medications

The Link Between Antidepressants & Dry Eye

Some anti-anxiety medications and tricyclic antidepressants (TCAs) can produce dry eye side effects. Antidepressants can block signals between nerve cells, including the ones that tell your nerve cells to make more tears. Types of TCAs include the following:

• Amitriptyline
• Clomipramine
• Doxepin
• Nortriptyline
• Imipramine
• Dosulepin/dothiepin

Studies have shown a strong association between antidepressants and dry eye disease from interference with aqueous and mucous secretions leading to a disruption in the ocular surface. These antidepressants can include selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs). 

SSRIs can include the following:

• Citalopram
• Fluoxetine 
• Fluvoxamine 
• Paroxetine 
• Sertraline 
• Escitalopram 

SNRIs can include the following:

• Venlafaxine 
• Desvenlafaxine 
• Duloxetine 

While severe side effects are uncommon, your eye doctor can help manage complications of dry eye disease when using antidepressants. 

Do All Antidepressants Cause Dry Eye?

While dry eye disease can be a potential side effect of some antidepressants, it is important to note that not all antidepressants have the same dry eye effects. There is no evidence of 1 particular antidepressant that will not lead to dry eye symptoms. 

However, based on some conclusions, SSRIs can affect tear film stability less than TCAs, and SNRIs can have less dry eye associations than SSRIs. Since responses can vary in individuals, your eye doctor and other healthcare professionals can advise you on which antidepressant to take. 

If you are considering or currently taking antidepressants and you experience bothersome side effects, consult your doctor before you take any action. You can also inform them about any existing eye conditions, concerns, and medications you are taking. 

Managing Dry Eye 

Whether you are on antidepressants or not, routine eye exams are essential. These exams can detect changes in your eye health and help monitor potential dry eye symptoms. If you take antidepressants, your eye doctor can provide tailored treatments to help you manage dry eye and maintain ocular comfort.

Hydration & Eye Drops

Staying adequately hydrated is vital for overall health, including eye health. Drinking enough water can contribute to tear production. Additionally, several types of eye drops, such as lubricating, gel, preservative-free, and prescription eye drops, can help relieve dry eye symptoms. 

Lifestyle Changes

Extended periods of screen time, whether for work or leisure, can reduce the frequency of blinking. Blinking is essential for distributing tears across the eye’s surface. Consider practicing blinking exercises and taking regular breaks to give your eyes a chance to rest and refresh.

Some research suggests that a diet rich in omega-3 fatty acids, found in foods like fatty fish, flaxseeds, and walnuts, may positively impact tear production and overall eye health. Including these foods in your diet can complement your efforts to manage dry eye symptoms.

Maintain Your Ocular Health

Antidepressants play a pivotal role in enhancing the lives of countless individuals grappling with mental health challenges. While the potential connection between these medications and dry eye syndrome is a concern, it is vital to approach this issue with understanding and a proactive mindset. 

Open communication with your healthcare provider and eye doctor can help them implement strategies to support your eye and overall health. If you are taking antidepressants and experiencing dry eye symptoms, visit an eye doctor near you for an exam, diagnosis, and a treatment plan tailored to your needs.