Evaluation of major depressive disorder in patients receiving chronic treatment with topical timolol.

Purpose: It was the aim of this study to evaluate the prevalence of major depressive disorder (MDD) in chronic glaucoma patients on a topical β-blocker (timolol).

Design: An observational case control study was performed.

Methods: The subjects recruited were divided into 3 groups. Group I included 98 patients with chronic glaucoma on topical β-blocker therapy, group II included 64 chronic glaucoma patients on prostaglandin analogues, and group III included 150 normal controls. All subjects were screened for MDD by the self-administered questionnaire Prime-MD Today (Primary Care Evaluation of Mental Disorders, New York, N.Y., USA).

Results: The control group had a significantly higher age (p < 0.001) compared to the glaucoma patients on timolol or prostaglandin analogues; 9/98 patients (9.2%) on timolol, 1/64 patients (1.5%) on prostaglandins and 3/150 (2%) control subjects were screened positive for MDD. The odds ratios adjusted for age, sex and duration of glaucoma showed that patients on β-blocker therapy were 6.4 and 4.9 times more likely to have depression compared to those on prostaglandin analogues and control subjects, respectively.

Conclusions: Glaucoma patients on topical timolol should be screened for depression and referred for appropriate psychiatric consultation and treatment if indicated.