Objective:

To investigate the potential association between carbonic anhydrase inhibitors (CAIs) and mood changes in glaucoma patients, emphasizing the clinical significance of these mood changes.

Key Findings:

• Topical CAI use was associated with a 25–35% higher hazard of depression, indicating a significant risk.
• There was nearly a twofold increase in the likelihood of antidepressant initiation in the early months after starting CAIs, highlighting the need for monitoring.
• Mood changes were evident as early as three months after treatment initiation, suggesting prompt assessment is necessary.

Interpretation:

Ophthalmologists should be more vigilant about monitoring neuropsychiatric symptoms in patients starting topical CAIs, especially in the initial months, and consider implementing routine mood assessments.

Limitations:

• The study may not account for all confounding variables influencing mood changes, including patient history and external factors.
• Routine screening for depression in clinical settings can be challenging due to time constraints and lack of integrated tools.

Conclusion:

The findings suggest a need for increased awareness of mood-related side effects of CAIs and highlight the importance of integrating mental health considerations into glaucoma care, along with educating patients about potential mood effects.