Psychiatric Medications That Cause Mydriasis

Medications with Strong Mydriatic Effects

Anticholinergic drugs used in psychiatry frequently cause mydriasis, including antihistamines with anticholinergic properties, tricyclic antidepressants, and sleep aids with anticholinergic properties, by blocking muscarinic receptors in the iris sphincter muscle, according to the American Academy of Pediatrics 1
Certain antipsychotics can cause mydriasis, particularly low-potency typical antipsychotics, as reported by the American Academy of Family Physicians 2

Mydriasis is a key physical examination finding in anticholinergic toxicity syndrome, characterized by mydriasis, dry mucous membranes, flushed skin, hyperthermia, and altered mental status, according to the American Academy of Pediatrics 1

Mydriasis can also occur in serotonin syndrome, but is not as characteristic as in anticholinergic toxicity, and other causes of mydriasis include sympathomimetic drugs, withdrawal from dopaminergic drugs, and neurological conditions, as noted by the American Academy of Pediatrics 1
In cases of anticholinergic toxicity with mydriasis, physostigmine may be considered for severe symptoms, as recommended by the American Academy of Pediatrics 1