rustler

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?

dr. leukoma

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

rustler

Thanks to Dr. G for his response:


Actually, the PDR includes "spasm of accommodation" as an adverse effect.
Evidently it blocks impulse transmiission at the synapses.

dr. leukoma

Spasm of accommodation, which can be painful, typically results from over-
use of accommodation. I know of at least one do***ented 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

rustler

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.