Question to general practitioner Maarten: Are my eye complaints caused by antidepressants?

Maarten Vasbinder lives in Isaan. His profession is general practitioner, a profession that he mainly practiced in Spain. On Thailandblog he answers questions from readers who live in Thailand.

Do you have a question for Maarten and do you live in Thailand? Send this to the editor: www.thailandblog.nl/contact/ It is important that you provide the correct information such as:

• Age
• Complaints)
• History
• Medication use, including supplements, etc.
• Smoking, alcohol
• Overweight
• Any laboratory results and other tests
• Possible blood pressure

Photos and attachments can be sent to [email protected] everything can be done anonymously, your privacy is guaranteed.

Dear Martin,

I have been taking Desirel (Trazodone) for panic attacks for several years. I also sleep very badly. My eyes have been bothering me for the past few months. Blurred vision. I've already been to the ophthalmologist, but he couldn't find anything.

Since I don't take any other medication, I wondered if it was because of the Desirel. You may say: stop taking anti-depressants, but that is not an option for me. I've tried that a few times and it didn't work.

Is switching to Fluoxetine an option? Or is there another anti-depressant that isn't bad for the eyes?

My age is 67 years old, BMI 25, blood pressure 120/70, heart rate 60.

Yours faithfully,

F.

******

Dear F,

Antidepressants can indeed cause eye problems. However, much attention has never been paid to it, nor to the side effects on the heart.
You can of course try another antidepressant of the same class (seretonin inhibitors) such as (fluoxetine (Prozac), but then you may be exposed to the same side effects.

As I said, little attention is paid to the side effects of antidepressants. They are blockbusters and they are defended tooth and nail by the industry. Bolckbusters in the pharmaceutical industry are resources that generate at least $ 1 billion in profit annually. with antidepressants and, for example, Satines, that is a multiple. Dr. Peter C. Gøtzsche has devoted an entire book to it: “Deadly Medicines and Organized Crime”.

The bad thing about antidepressants is that they don't work, except that they have a nocebo effect, which means that they do do something that makes you feel different, which you translate as an improvement.

Depression is a terrible disease. Especially the endogenous depression, which is often genetically determined. The exogenous depression is caused by outside events and passes on its own in most people unless they are put on antidepressants or are constantly complained about.

You are right in saying that it is very difficult to stop taking antidepressants. However, it is possible with a lot of patience. A good method in the case of Trazadone is to reduce by 50 mg per week. If you take 300 mg per day, that would mean that withdrawal takes 42 weeks. If you take a lower dose, you can reduce 25 mg per week. In my practice, this almost always worked. You will then need to make a schedule for the number of pills you can take. Make sure that the intake is distributed as evenly as possible over the days of the week. For some people it can be faster, but since you have been on this addictive medication for several years, it is better to start slowly. Some people go to an addiction clinic to get out of the prison of antidepressants.

As far as your eyes are concerned, it is of course not certain that Trazodone is the cause. You may also have cataracts. You can determine this by looking eye to eye through a small tube (a few mm). If you see clearly then it means that your central vision is intact, but your peripheral vision is not. In many cases, this is one of the characteristics of cataracts. You can make such a tube with your fist.

Insomnia is also one of the side effects of Trazodone.

Yours faithfully,

Dr. Maarten

Do you have a question for Maarten and do you live in Thailand? Send this to the editor: www.thailandblog.nl/contact/ It is important that you provide the correct information (see list at the top of the page).