Which medication is least likely to cause anticholinergic effects, making it safer for patients with glaucoma?

Bupropion is the medication least likely to cause anticholinergic effects, which makes it a safer choice for patients with glaucoma. Anticholinergic effects can lead to increased intraocular pressure, which can exacerbate glaucoma.

Bupropion primarily acts as a norepinephrine-dopamine reuptake inhibitor and does not significantly block muscarinic acetylcholine receptors, thereby minimizing the risk of anticholinergic side effects such as dry mouth, constipation, urinary retention, and visual disturbances.

In contrast, medications like amitriptyline, which is a tricyclic antidepressant, have strong anticholinergic properties due to their ability to block these receptors. Sertraline and fluoxetine, both selective serotonin reuptake inhibitors (SSRIs), have a lower potential for anticholinergic effects compared to tricyclics, but they can still cause mild anticholinergic symptoms in some patients. Therefore, Bupropion stands out as the safest option for individuals with a risk of elevated intraocular pressure associated with glaucoma.