What is the relationship between Clozapine (Clozaril) and dry eye syndrome, also known as xerophthalmia?

From the Research

Relationship Between Clozapine and Dry Eye Syndrome

• Clozapine, an anti-psychotic drug, may induce dry eye syndrome due to its anticholinergic and antidopaminergic activities 1.
• A study found that patients taking clozapine had lower Schirmer test scores and shorter fluorescein break-up time, indicating dry eye syndrome 1.
• The use of clozapine may lead to morphological alterations in corneal parameters, which can be significant in patients with diseases like glaucoma or those undergoing corneal refractive surgery 1.

Association with Other Systemic Medications

• Certain systemic medications, such as antihistamines, aspirin, corticosteroids, and seizure medications, may be associated with more severe dry eye disease 2.
• The use of these medications can affect tear film stability and ocular surface health, leading to dry eye syndrome 2.

Psychiatric Disorders and Dry Eye Disease

• There is a possible association between dry eye disease and psychiatric disorders, such as anxiety, depression, schizophrenia, and post-traumatic stress disorder 3.
• Psychiatric medications, including clozapine, can influence tear film status and increase the risk of dry eye disease 3.
• A transdisciplinary approach is necessary to address the relationship between psychiatric disorders and dry eye disease, involving both psychiatrists and ophthalmologists 3.

Other Relevant Findings

• A study found that 70% of patients with depression had dry eye syndrome, with older patients and those taking antidepressants for longer periods being more likely to develop dry eye 4.
• The use of antidepressants may be considered a potential cause of dry eye syndrome 4.