EFFECT OF LONG TERM HIGH DOSE ANTI-DEPRESSANT MEDICATION ON TEAR FILM STABILITY, A DESCRIPTIVE CROSS-SECTIONAL STUDY

Abstract

Purpose: The primary aim of this research was to explore the relationship between long-term antidepressant use and the development of dry eye disease (DED). In addition, the study compared the ocular surface effects of two commonly prescribed antidepressant medications—escitalopram and sertraline—to determine whether one posed a higher risk of inducing dry eye symptoms than the other. Methods: A descriptive cross-sectional study was carried out between NOVEMBER 2023 and NOVEMBER 2025 at MAYO HOSPITAL, LAHORE. Participants using either escitalopram or sertraline were selected through purposive sampling. After obtaining informed consent, each individual underwent a Schirmer test to evaluate tear production, and the Ocular Surface Disease Index (OSDI) questionnaire was administered to assess symptom severity. All collected data were entered and analyzed using SPSS version 20. Chi-square tests were applied to determine the statistical significance of associations between antidepressant use, duration of intake, and dry eye findings. Results: A total of 180 subjects aged 20–40 years, including both males and females, were evaluated. Analysis revealed a strong association between dry eye disease and the duration of antidepressant usage, with longer treatment periods showing significantly higher rates of reduced tear production and increased symptom scores (p < 0.001). When comparing the two medications, no statistically significant difference was found in the likelihood of developing dry eye between users of escitalopram and those of sertraline (p = 0.488). This indicates that both drugs contribute similarly to tear film alteration and ocular surface discomfort. Conclusions: indings from this study emphasize the importance of considering ocular side effects in patients undergoing long-term antidepressant therapy. Prolonged use of either escitalopram or sertraline is associated with a higher risk of dry eye disease, underscoring the need for routine ocular assessment and detailed medication history in affected individuals. Eye care practitioners and other healthcare providers should remain aware of this association to ensure early detection and effective management of dry eye symptoms in antidepressant users.

Keywords: Antidepressants, Dry eye disease, Schirmer test, OSDI, escitalopram, sertraline, ocular surface