Evidence map›Paper›PMID 41388160›Full record

SynthesisCNS drugs2026

The Effect of Psychotropic Medications on Glaucoma Risk and Intraocular Pressure: A Bayesian Meta-Analysis.

Tommaso B Jannini, Ludovico Alisi, Francesca Giovannetti, Marta Armentano, Giorgio Di Lorenzo, Cinzia Niolu, Alberto Siracusano

Abstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in CNS drugs, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Tommaso B Jannini *Department of Experimental Medicine, Tor Vergata University of Rome, Rome, Italy.ORCID 0000-0003-2936-4150
Ludovico Alisi *Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, Rome, Italy.ORCID 0000-0001-5366-882X
Francesca GiovannettiDepartment of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, Rome, Italy.ORCID 0000-0002-7661-6675
Marta ArmentanoDepartment of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, Rome, Italy. marta.armentano@uniroma1.it.ORCID 0009-0005-3414-6344
Giorgio Di LorenzoChair of Psychiatry, Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy.ORCID 0000-0002-0576-4064
Cinzia NioluChair of Psychiatry, Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy.ORCID 0000-0001-6173-2684
Alberto SiracusanoChair of Psychiatry, Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy.ORCID 0000-0001-8406-093X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectivesGlaucoma is one of the leading causes of irreversible blindness worldwide and is increasingly recognized as a potential adverse effect of various pharmacological agents. It has been suggested that psychotropic medications influence glaucoma risk, but findings across studies have remained inconsistent. We aimed to clarify the association between psychotropic drug use and glaucoma through a Bayesian meta-analysis.

methodsWe conducted a systematic literature search up to December 2024. Studies that examined the relationship between psychotropic medications and glaucoma or intraocular pressure (IOP), and reported odds ratios (ORs), relative risks (RRs), or mean differences, were eligible. Bayesian random-effects models were applied using informative priors based on existing evidence for specific compounds. Estimates were reported as pooled ORs and Hedges' g with corresponding 95% credible intervals (CrIs).

resultsA total of 22 observational studies, including 293,228 users of psychotropic medications, met the inclusion criteria. Selective serotonin reuptake inhibitors (SSRIs) were associated with a modestly reduced risk of open-angle glaucoma (OR = 0.832, 95% CrI: 0.753-0.921) and a small but consistent reduction in IOP (Hedges' g = -0.332, 95% CrI: -0.487 to -0.179). Although tricyclic antidepressants were expected to have a direct causative effect, results did not show a significant association with glaucoma risk (OR = 1.466, 95% CrI: 0.700-3.338). Benzodiazepines were associated with a significantly increased risk of glaucoma (OR = 1.550, 95% CrI: 1.436-1.674), with consistent effects across both short- and long-acting compounds. Topiramate demonstrated a strong association with acute angle-closure glaucoma (OR = 3.930, 95% CrI: 1.784-11.465), in accordance with its known mechanism of inducing anterior displacement of the lens-iris diaphragm. Studies on methylphenidate, limited to pediatric populations, suggested a modest but non-significant reduction in IOP compared with untreated individuals. Evidence on antipsychotics was inconsistent, precluding any quantitative synthesis.

conclusionsWhile some drug classes (e.g., benzodiazepines, topiramate) show a strong association with glaucoma, results for other compounds must be taken judiciously. The high level of heterogeneity, and the presence of special populations suggest caution when moving to real-life scenarios. Nonetheless, our results highlight the importance of ophthalmologic monitoring in patients prescribed with psychiatric drugs (e.g., benzodiazepines or topiramate), at risk for angle closure.

Indexed as

GlaucomaIntraocular PressurePsychotropic DrugsBayes TheoremHumansObservational Studies as TopicPsychotropic Drugs

Identifiers

PMID41388160
PMCPMC12909488

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.