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Medical Forum / General / Vision / June 2004Blurred vision after a week on new RX
After a little over a week on Elavil (1 tablet at bedtime as a sleep aid) my near (reading) vision is shot. Normally I don't need glasses, but had to get some "reading glasses" to be able to see anything close, and even with the glasses things aren't that clear. Side effects listed for the drug include blurred vision and spasm of accommodation. However, spasm of accommodation would appear to have the opposite effect--loss of distant clarity, instead of near. If I stop taking the pills how long should I have to wait for vision to return to normal? Comments? > After a little over a week on Elavil (1 tablet at bedtime as a sleep > aid) my near (reading) vision is shot. Normally I don't need glasses, [quoted text clipped - 9 lines] > > Comments? Elavil is a tricyclic antidepressant, and has significant anticholinergic side-effects. It would not be expected to cause spasm of accommodation, but would be expected to interfere with accommodation, and would likely relieve spasm of accommodation. I believe that it takes several days for the body to clear Elavil, perhaps up to one week. You may want to consult a PDR. DrG Thanks to Dr. G for his response: >Elavil is a tricyclic antidepressant, and has significant anticholinergic >side-effects. It would not be expected to cause spasm of accommodation, >but would be expected to interfere with accommodation, and would likely >relieve spasm of accommodation. I believe that it takes several days for >the body to clear Elavil, perhaps up to one week. You may want to consult >a PDR.< Actually, the PDR includes "spasm of accommodation" as an adverse effect. Evidently it blocks impulse transmiission at the synapses. > Thanks to Dr. G for his response: > [quoted text clipped - 7 lines] > Actually, the PDR includes "spasm of accommodation" as an adverse > effect. Evidently it blocks impulse transmiission at the synapses. Spasm of accommodation, which can be painful, typically results from over- use of accommodation. I know of at least one documented case where Elavil relieved accommodative spasm. But, that's not your problem, is it? Your problem is that Elavil has impaired your ability to accommodate, right? DrG DrG wrote: >Spasm of accommodation, which can be painful, typically results from over- >use of accommodation. I know of at least one documented case where Elavil >relieved accommodative spasm. But, that's not your problem, is it? Your >problem is that Elavil has impaired your ability to accommodate, right?< I can't say 100% that Elavil impaired my accommodation, however the problem didn't come up until several days after starting the drug, and that was the only change I am aware of in my routine. I can see that Elavil might relieve a spasm in the muscle controlling the lens as it evidently interferes with nerve impulses being transmitted--in fact, it would seem quite likely that such would be the case. If that's what's happening, then a person would assume that normal impulses for pulling on the lens to see close objects could also be blocked. So both of these points appear to demonstrate similar action. |
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