Short-term harms of Mydriapid eye drops
A 2022 clinical review of tropicamide misuse describes effects that appear within minutes of injection, and vary in severity with the amount used and what else is mixed with it.
- Excitement, agitation and a racing heartbeat.
- Hallucinations and delirium, and what some patients describe as “dreaming with open eyes.”
- Low mood and severe distress, or loss of consciousness.
- Strange behavior while under the effect, such as picking at things that are not there on the floor and walls, or staying in an uncomfortable position for a long time.
- Forgetting what happened while under the effect, to the point that some patients only learned of their hallucinations from what people around them told them.
Severe poisoning: the heart and seizures
According to the same review, the most serious picture of anticholinergic poisoning includes coma, seizures, and a racing and irregular heartbeat caused by their effect on the electrical conduction of the heart muscle. Seizures have been recorded with tropicamide in children and adults, including a 62-year-old patient who had a generalized seizure with a pause in breathing 30 minutes after an eye examination.
If these rare events have happened with medical use in the eye, then injecting the contents of the bottle into a vein puts the heart and brain at far greater risk, especially when heroin, which can slow breathing, is also involved.
Harms of Mydriapid eye drops on the body's systems
| System | Possible harms |
|---|---|
| Brain | Delirium, hallucinations, psychosis and paranoid suspicion, with seizures and loss of consciousness in severe cases. |
| Heart | A racing and irregular heartbeat, and reports of toxic damage to the heart muscle (cardiomyopathy) with long-term use. |
| Liver | Reports of toxic hepatitis, cirrhosis and liver failure. |
| Kidneys | Reports of kidney failure, with difficulty passing urine or urinary retention. |
| Digestive system | Paralysis of bowel movement in some cases. |
| Skin | Dehydration and fever, and leg ulcers and vein disease in people who inject into the femoral veins or superficial veins. |
The review adds fever, tremor and severe anemia, and cites Russian doctors who found that people who use heroin and added the drops lost 5 to 8 kilograms over two to three months. It also notes that tropicamide may build up in the body's organs and fluids with repeated use.
Harms of injecting itself
The harms of the drops do not come only from the substance but also from how it is used. Repeated injecting, especially into the large veins of the thigh, is linked to vein damage, leg ulcers and infection at the injection site. Sharing syringes spreads hepatitis viruses and HIV; in the interviews the review's authors held with five people in recovery, three of them had hepatitis C.
That is why anyone who has injected the drops or any other substance needs testing for hepatitis viruses and HIV as part of the treatment plan, even if they feel fine.
Harms of mixing the drops with heroin
Most of the people described in the reports were injecting the drops together with heroin in the same syringe. Patients say the drops strengthen and prolong the “high,” which greatly increases how often they inject, and with it all the harms of injecting and the risk of the harms of heroin itself. The review presents a comparison from a study of 60 patients:
| Measure | Opioids alone (30 patients) | Opioids with the drops (30 patients) |
|---|---|---|
| Average duration of withdrawal symptoms | About 5 days | About 10 days |
| Severity of the usual withdrawal symptoms | Lower | Significantly higher |
| Psychological symptoms during withdrawal | Lower | Significantly higher |
The researchers also see the added drops as a possible driver of continued use and a reason treatment outcomes are harder, which makes telling the doctor about them essential.
Harms of Mydriapid eye drops on mental health
A feeling of being followed, and refusing food for fear of poisoning, in some people who combined the drops with stimulants.
Severe distress and depression after the effect wears off, which one patient described as harder than anything he had gone through with any other substance.
Forgetting what happens during use, and possible cognitive impairment with prolonged blockade of acetylcholine receptors.
Cravings that patients describe as stronger than their desire for opioids alone.
Some patients describe thoughts that life is pointless during the crash phase. If you notice this in someone you love, do not leave them alone, and get help immediately through the mental health support line (16328) or ambulance (123). If hallucinations or suspicion continue after stopping, an assessment may be needed, as in cases of drug-induced psychosis.
Who is most at risk from the harms of the drops?
- People who use opioids: they are the group most often mentioned in the reports, and the risk of the drops adds to the risk of overdose.
- People with mental illness or intellectual disabilities: the review notes that misuse of eye drops is widespread among them.
- Older adults: anticholinergic hallucinations may appear at lower amounts, especially when memory is impaired.
- People with heart disease: because a racing heart and rhythm disturbance are more dangerous for them.
Do the harms of the drops go away after stopping?
The review states that the symptoms caused by this substance are reversible once it is stopped, which applies mainly to delirium, hallucinations and anticholinergic symptoms. Damage to the liver, kidneys and heart, viral infections and vein damage need testing, treatment and follow-up, and some may remain. That is why stopping early, with a comprehensive medical assessment, is the best way to protect the body, and you will find the steps in Mydriapid eye drop addiction treatment.
Danger signs after using Mydriabid drops: call an ambulance (123) immediately
- Seizures, loss of consciousness, or no response to calling
- Slow or weak breathing, especially if the drops were mixed with heroin or other opioids
- Severe palpitations, an irregular pulse or chest pain
- High fever with hot, dry skin and very wide pupils
- Delirium or severe agitation with a risk of harming themselves or others
Call an ambulance on 123 immediately. If the person is unconscious but breathing, place them on their side so they do not choke on vomit. Stay with them and do not leave them alone, keep syringes and sharp objects away from them, give them no medication or other substance, and tell the paramedics that they used eye drops and everything else they took with them.
Call the ambulance 123