Which two classes of medications are contraindicated in narrow angle glaucoma?

In the context of narrow angle glaucoma, it is important to understand that certain medications can exacerbate the condition by causing pupil dilation. This dilation can lead to increased intraocular pressure, which is particularly harmful for individuals with narrow angle glaucoma.

Tricyclic antidepressants (TCAs), such as Amitriptyline and Nortriptyline, are contraindicated in this condition because they possess anticholinergic properties. These properties can result in mydriasis (pupil dilation) and, thereby, increase the risk of an acute glaucoma attack in susceptible patients.

In contrast, the other classes of medications listed—SSRIs, SNRIs, anticonvulsants, and lithium—do not carry the same level of risk for causing pupil dilation or increasing intraocular pressure in the context of narrow angle glaucoma. Therefore, the correct identification of TCAs, specifically Amitriptyline and Nortriptyline, is pivotal in understanding the management of patients with this ocular condition.