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The Links Between Some Medications & Dry Eyes: Antidepressants, HRT & More

Common medications, including antidepressants, HRT and antihistamines, are used to manage different health conditions and symptoms. However, some medications can have various side effects for some people, one of which can include dry eye symptoms. We always recommend you speak with your GP should you experience any side effects from medications you’re taking.

Here, we’ll be explaining why some people may experience medication-related dryness, common signs to look out for, and ways to manage the discomfort of dry eye, alongside highlighting the importance of speaking to a healthcare professional about any issues with your eyes.  

Which medications can have an associated increased risk of dry eye? 

Certain medications may contribute to the development of dry eye. To help you understand the potential reasons for this, we’re sharing some background information on some common medications and how they may be linked to an increased risk of dry eye.

Antidepressants

Some antidepressant medications, such as tricyclics e.g. (Amitriptyline), are used to block some nerve signals in the body, including a neurotransmitter called acetylcholine, to help overcome depression. However, this can also play a role in the secretion of tears by the lacrimal glands, which sit above the eyes. Therefore, in some cases, taking this medication may reduce tear production and potentially increase the risk of dry eye.1 

Chronic pain relief

Some types of medication that are used for chronic pain relief such as Amitriptyline and nonsteroidal anti-inflammatory drugs (NSAIDs) e.g. Diclofenac, may lead to lower tear production due to reduced corneal sensitivity. This may increase the likelihood of experiencing dry eye when taking this medication.3 

Antihistamines

Antihistamines such as cetirizine hydrochloride are commonly taken during the peak hay-fever season to help relieve allergy symptoms like sneezing or itchiness.

However, due to the impact that antihistamines have on the lacrimal gland, these medications may cause the eyes to produce less tears, ultimately resulting in drier eyes.4  

Contraceptives 

Contraceptive medications often cause hormonal changes, such as increased oestrogen, which can alter tear film stability. For some people, this may impact the production of the oily layer of the tear film and increase the risk of evaporative dry eye.5 

Hormone Replacement Therapy (HRT)

Natural hormonal fluctuations that may be experienced during the menopause can impact the performance of the meibomian glands and the production of tears, which may result in dry eyes.6 Oestrogen-only or oestrogen-dominant HRT can also affect the meibomian glands, reducing the quality of the tear film2 increasing the risk of evaporative dry eye.

Acne medication

Some acne medications, such as isotretinoin, are designed to reduce the amount of oil produced in the body. This may affect the meibomian glands and potentially contribute to the development of dry eyes.7 

Blood pressure medication

Blood pressure medications, such as beta blockers or diuretics, may be taken by those with conditions like hypertension or other cardiovascular disease, and possibly diabetes if it co-exists. These medications can lower tear production from the lacrimal glands, which may lead to an increased risk of dry eye.

Other medications that may increase the risk of dry eye

Several other medications taken to manage other health conditions may also increase the risk of dry eye for various reasons. Other medications that could be linked to the condition include antipsychotics8.

Common symptoms of dry eye

So, what signs should you look out for? Here are some of the most common symptoms of dry eye: 

  • Gritty, sore eyes
  • Tired eyes
  • Red eyes
  • Watery eyes
  • Itchiness
  • Sensitivity to environmental irritants
  • Reduced contact lens comfort 

Ways to manage dry eyes caused by medication 

We’ve put together some helpful tips below to help you manage and alleviate any symptoms of dry eye that may be caused by medications you’re taking. 

Speak to a medical professional

Be sure to review the prescription or medication you’re taking and speak to your healthcare provider about any symptoms of dry eye you’re experiencing. They will be able to offer you advice and support. 

Use dry eye products to help with symptoms

At Théa, we recommend using products such as Thealoz® Duo, Thealoz® Duo Gel and Hyabak® to help alleviate common dry eye-related symptoms. 

To help with managing the symptoms of dry eye, explore Théa’s dry eye relief range. 

If you’re experiencing any dry eye-related symptoms that could be linked to other medications, we recommend seeking the support of healthcare professionals.

 

References:

  1. Imayilov AS, Celikel G. Effects of tricyclic antidepressants, selective serotonin reuptake inhibitors, and selective serotonin-norepinephrine reuptake inhibitors on the ocular surface. Arq Bras Oftalmol. 2022 Oct 13;86(5):e20230068. doi: 10.5935/0004-2749.20230068. PMID: 35544938; PMCID: PMC11826536.
  2. Feng Y, Feng G, Peng S, Li H. The Effect of Hormone Replacement Therapy on Dry Eye Syndrome Evaluated with Schirmer Test and Break-Up Time. J Ophthalmol. 2015;2015:420302. doi: 10.1155/2015/420302. Epub 2015 Nov 18. PMID: 26664737; PMCID: PMC4667056.
  3. Nguyen A, Kolluru A, Beglarian T. Dry eye disease: A review of anti-inflammatory therapies. Taiwan J Ophthalmol. 2023 Feb 13;13(1):3-12. doi: 10.4103/2211-5056.369606. PMID: 37252177; PMCID: PMC10220443.)
  4. Paulsen AJ, Cruickshanks KJ, Fischer ME, Huang GH, Klein BE, Klein R, Dalton DS. Dry eye in the beaver dam offspring study: prevalence, risk factors, and health-related quality of life. Am J Ophthalmol. 2014 Apr;157(4):799-806. doi: 10.1016/j.ajo.2013.12.023. Epub 2014 Jan 2. PMID: 24388838; PMCID: PMC3995164.
  5. He B, Iovieno A, Etminan M, Kezouh A, Yeung SN. Effects of hormonal contraceptives on dry eye disease: a population-based study. Eye (Lond). 2022 Mar;36(3):634-638. doi: 10.1038/s41433-021-01517-x. Epub 2021 Apr 6. PMID: 33824509; PMCID: PMC8873413.
  6. Gorimanipalli B, Khamar P, Sethu S, Shetty R. Hormones and dry eye disease. Indian J Ophthalmol. 2023 Apr;71(4):1276-1284. doi: 10.4103/IJO.IJO_2887_22. PMID: 37026259; PMCID: PMC10276676.
  7. Zakrzewska A, Wiącek MP, Słuczanowska-Głąbowska S, Safranow K, Machalińska A. The Effect of Oral Isotretinoin Therapy on Meibomian Gland Characteristics in Patients with Acne Vulgaris. Ophthalmol Ther. 2023 Aug;12(4):2187-2197. doi: 10.1007/s40123-023-00737-6. Epub 2023 Jun 10. PMID: 37301783; PMCID: PMC10287853.
  8. Balogun, Modupe & Coker, Ayodele. (2023). Dry Eyes Illness in Psychiatric Patients Placed on Antipsychotic Medications. Journal of Behavioral Health and Psychology. 12. 10.33425/2832-4579/23059.
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