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Blurred vision from an anticholinergic effect happens when muscarinic receptors in the eye are blocked, hindering the eye’s ability to adjust focus for near objects. Tricyclic antidepressants have strong antimuscarinic properties, meaning they block these receptors widely, including in the eye. That makes blurred vision a common side effect with these drugs, along with other anticholinergic effects like dry mouth and constipation.

The other classes don’t routinely produce this pattern as a hallmark side effect. SSRIs mainly affect serotonin and are more tied to sexual dysfunction and GI symptoms; MAO inhibitors carry dietary and hypertensive concerns; atypical antipsychotics have varied side effects (like metabolic issues and EPS) and are not defined by anticholinergic blurred-vision effects.