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Possible paroxetine-induced
bruxism.
Romanelli F, Adler DA, Bungay
KM.
University of Kentucky Medical Center, Lexington 40536,
USA.
OBJECTIVE: To report the case of a patient with possible
paroxetine-induced bruxism that was effectively treated with buspirone.
CASE SUMMARY: A 20-year-old woman with no active medical conditions
besides acne and no history of dental problems was seen in an outpatient
psychiatry clinic for the evaluation of ongoing depression. The patient
was prescribed paroxetine 10 mg every morning. After 5 days of therapy
the patient reported no adverse effects, and the paroxetine dosage was
increased to 20 mg every morning. Due to increased somnolence, the
dosing schedule was subsequently changed to 20 mg hs. Two months later
during a dental visit for a tooth extraction, the dentist noted that the
patient's teeth appeared damaged in what he believed to be a pattern
consistent with the grinding and clenching of teeth. Prior to this time,
dental examinations had not revealed any tooth damage. The patient was
thought to have paroxetine-induced bruxism and, based on earlier case
reports, was treated with buspirone 5 mg hs. On day 4 of buspirone
therapy the patient reported a significant reduction in the extent of
gritting, tooth pain, and jaw tenderness. DISCUSSION: The selective
serotonin reuptake inhibitors (SSRIs) fluoxetine and sertraline have
been associated with bruxism in previous reports. This case suggests
paroxetine-induced bruxism. The exact mechanism of SSRI-induced bruxism
remains unclear. Many theories have been proposed, including sleep
disturbance, serotonergic-mediated inhibition of dopamine manifesting as
akathisia, and SSRI-induced anxiety. According to published reports,
SSRI-induced bruxism may respond to therapy with buspirone. Consistent
with these reports, this patient responded favorably to buspirone
therapy. CONCLUSIONS: Clinicians should be aware that the potential for
paroxetine-induced bruxism exists and that buspirone may be an
appropriate therapeutic intervention.
Publication Types:
PMID: 8913405 [PubMed - indexed for
MEDLINE]
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