Severe anxiety med and glaucoma

I’ve just been diagnosed with glaucoma. I have severe chronic anxiety that is resistant to all the regular SRi SNRI and triptylines apart from 20 mg duloxetine. I can’t take a higher dose because I have unbearable side effects and I have no found out Duloxetine is on the list of tablets not to take with glaucoma. My GP isn’t interested in finding out about this. The only thing iv3 found on Dr Google is Bupropion ( this is not for anxiety, it is used for depression in US ) and in the uk this is only prescribed for smoking cessation and is not prescribed off label. I’m at the end of my tether.

[Dolphin14]

Felix125

I think you should use your eye Dr as the resource for your meds. Have you talked to him/her

🐬

[Hidden in reply to Dolphin14]

Unfortunately here in the UK, clinicians don’t speak to each other and have no interest outside their specialty. Eye dr says speak to gp, gp says speak to eye dr. This is a real problem in the uk. A person can be treated by different departments for different conditions but the6 never meet or communicate, which obviously can have serious consequences where medication is concerned. I think the US are streets ahead of the uk medically.

[Dolphin14 in reply to Hidden]

This is a bit frightening. Does the pharmacist get involved at all? Can they recommend the safest medication?

[Hidden in reply to Dolphin14]

Tge pharmacist tells me just to read the leaflet with the accompanying meds !

[Dolphin14 in reply to Hidden]

Wow.... I'm so sorry you have to go through this.

I'm speechless and consider myself lucky with the particular health care I have

[blackcat64013]

Hi Felix125, Thank you for your post. 👍

I understand your issue because I am difficult to treat patient too.

The main thing is not to give up on getting the best medical advice. Tell your GP that you are not a happy patient. This is often easier said than done. Don't give up.

Ask for a 2nd (expert) opinion from either an eye specialist or a psychiatrist who use their clinical expertise to find the best solution for you.

My psychiatrist, luckily for me is always up for a challenge from my GP. They are both on my care plan.

All the best 🐈‍⬛

[Jeff1943]

Is your glaucoma closed angle or open angle? If it's the latter then antidepressants are not a problem, it's only if you have closed angle glaucoma that antidepressants can increase intraocular pressure. Most GPs are not aware of this fact, after all they are not specialists. Very few anxiety/depression therapists know this. Only good ophthalmologists are aware of this. Do get medical confirmation that Duloexatine is OK for open angle glaucoma.

I think your criticism of the way the UK medical service works is based on a misunderstanding. All the different specialists that you visit send a detailed report back to your GP so he or she has an informed overview of your condition. Under NHS rules you can ask for a copies to be sent to you.

P.S. I just checked this medication on Wikipedia - it's only uncontrolled narrow/closed angle glaucoma that it can cause eye pressure to rise. So it's o.k. to take it with controlled narrow angle and open angle glaucoma.

[Hidden in reply to Jeff1943]

Thanks for that information. My criticism of the NHS is from lived in experience of the poor treatment that I and my family members have received over the years. In fact one of my close family members who almost died received formal acknowledgment of the mistakes made from the NHS because of what happened. Because of this I always make sure that I double check everything and try the best that I can to co ordinate the different departments within the NHS. I always get the copies of the letters sent to my GP. My GP does not act as a coordinator though and does not seem to be able to join the dots with how my multiple chronic conditions have an impact on each other. The problem is the non existent communication and coordination between different departments. I have been offered medication for conditions on numerous occasions that I have that could have sent me to the hospital if I had taken them.

[Hidden in reply to Jeff1943]

I have researched clinical papers on duloxetine and it does increase eye pressure wether open or closed angle, but I agree that generally SRIs/ SNRIs do seem to increase pressure in closed angle. However there is quite a lot of conflicting research, unsurprisingly depending who authorised it! It is difficult to find unbiased empirical peer, double blind and peer reviewed research that is available on the net. I will just need to take an individualised approach I think. Interestingly every anti anxiety medication that I have taken has always affected my vision and made things more blurry. The less I take of any medication, then my vision improves…. which is so frustrating because I can’t manage without my anti anxiety med.

[Jeff1943 in reply to Hidden]

So you're saying the information on Wikipedia which sounds quite authoritive saying its OK to take that med so long as you have controlled closed angle or open angle glaucoma is wrong. Wow!I have open angle glaucoma in one eye and took amitriptyline for years without it raising eye pressure.

I was in contact recently on this forum with a lady who needed antianxiety meds but was denied it because she had glaucoma and only after a lot of investigation did the doctors admit it was safe to take her anti anxiety med.

Sorry your local medical service is letting you down, down here in Surrey we get prompt attention from doctors and GPs who care, suppose it depends where you live.

[Hidden in reply to Jeff1943]

I live in NW England. I haven’t been able to get a GP appt for 9 months other than by telephone.

[Hidden in reply to Jeff1943]

I think your criticism of the way the UK medical service works is based on a misunderstanding. All the different specialists that you visit send a detailed report back to your GP so he or she has an informed overview of your condition

Sorry Jeff. That’s not my experience. I have a complex medical history and joined up thinking is absent.

[Jeff1943 in reply to Hidden]

Porridge37, I was of course forgetting that the quality of NHS care is patchy throughout the UK and in south-west London where I come from both GP and hospital care are very good.It's outrageous that you have to wait 9 months for a GP appointment, time to rattle the bars of the cage?