Difficulty reading fine print, and dryness of the eyes, are almost inevitable in people taking the older tricyclic antidepressants, and also occur in a minority of people taking the newer antidepressants.  These are part of what are called the anticholinergic side effects of antidepressants, as these antidepressants interfere with the cholinergic transmission pathway in our body, which looks after many automatic functions such as the production of tears, the automatic adjustment of our eyes when focussing, and the production of saliva.



People with glaucoma (increased pressure inside the eye) or at risk of developing glaucoma (especially those in late middle age or older), need to be especially careful using these antidepressant agents.  Your eye specialist can check your eye pressure, and advise whether or not an increase in eye medication is necessary to compensate.


SIMPLE MAGNIFYING READING GLASSES will compensate for the blurring of vision and difficulty reading fine print in many cases.  These glasses can usually be bought in pharmacies or drug stores, and there is no need to have expensive prescription glasses made up simply to deal with this side effect of tricyclic antidepressants.


ARTIFICIAL TEARDROPS: These medications not only cause dry mouth, but also dry eyes.  Adequate fluid in the eyes is necessary to see clearly, otherwise blurring of vision does occur. Indeed, the problem is made worse when we have blurring of vision by our automatic instinct to stare more intensely at what we are reading or looking at, and deliberately blinking less. This actually reduces the ability of the eyes to spread tears and fluid within the eye, actually resulting in the situation that staring makes blurring of vision worse!


For many people therefore, it will be very useful to regularly apply ARTIFICIAL TEARS to their eyes, so that this contribution to blurring of vision is removed.


BETHANECHOL (UROCARB) is a simple antidote, which will relieve the anticholinergic side effects of antidepressants in the majority of people.  This medication normally has no side effects itself, and needs to be taken in a dose of 10-20 mgs three times per day usually. While the timing of the medication is not an issue for the majority of people, some people find Bethanechol works far better if taken on an empty stomach, and half an hour before any food is consumed.



In some cases, it may be possible for your doctor to change your tricyclic antidepressant to one with fewer anticholinergic side effects in most people, (eg Nortriptyline or Dothiepien), or consider Mianserin, a derivative of the tricyclic antidepressants with no anticholinergic side effects.  However, do keep in mind that a new antidepressant may not necessarily give you the same benefits as the one you are currently taking.


This information is intended to improve your knowledge of the treatment you are receiving.  Any further points can be discussed at your next consultation with your doctor.


Important Disclaimer:  This site is medical information only, and is not to be taken as diagnosis, advice or treatment, which can only be decided by your own doctor.

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