Why Do SSRIs Cause Jaw Clenching?

Why do SSRIs cause jaw clenching? While the exact mechanism is unknown, it appears that SSRIs trigger jaw clenching because of their effect on the level of neurotransmitters like serotonin in the brain. These neurotransmitters control mood, but they also contribute to movement regulation.

Recent clinical evidence points to a significant association between selective serotonin reuptake inhibitor (SSRI) antidepressant drugs and jaw clenching. These drugs are among several confirmed medications that cause bruxism (the medical term for repetitive jaw clenching and/or teeth grinding). The effect is not permanent, as SSRI jaw clenching starts around 3 weeks after starting the medication and resolves 3 weeks after stopping.

Here’s what you need to know about antidepressants and jaw clenching, and how to get jaw pain relief in the meantime.

Antidepressants and Bruxism

In a 2020 article in the journal BMC Psychiatry, researchers found that compared to all other medications, your chances of reporting bruxism when taking antidepressants are 10 times higher than they are with any other type of medication.

The same researchers compared the classes of antidepressant drugs to see which were more closely associated with bruxism. The two related classes of antidepressants with the strongest association with clenching were the SSRIs and the serotonin-norepinephrine reuptake inhibitors (SNRIs).

Here are the common SSRI drugs with their brand names:

  • Fluoxetine (Prozac)
  • Sertraline (Zoloft)
  • Citalopram (Celexa)
  • Escitalopram (Lexapro)
  • Paroxetine (Paxil)
  • Vortioxetine (Trintellix)

Out of these, Zoloft, Celexa, and Trintellix had a statistically significant association with bruxism, according to the study parameters.

Here are some common SNRI drugs with their brand names:

  • Duloxetine (Cymbalta)
  • Venlafaxine (Effexor XR)

Both Cymbalta and Effexor had a statistically significant association with bruxism.

Antidepressants That Don’t Cause Bruxism

In the same 2020 article, researchers compared three different classes of antidepressants to see their relationship with jaw clenching. As opposed to the SSRI/SNRI class, there was no association with bruxism found in either the tricyclic antidepressant class or the monoamine oxidase inhibitors (MAOI) class.

Common tricyclic antidepressants with their brand names include:

  • Amitriptyline (Elavil)
  • Doxepine (Sinequan)
  • Imipramine (Tofranil)
  • Nortriptyline (Pamelor)
  • Clomipramine (Anafranil)
  • Trimipramine (Surmontil)

Common MAOI antidepressants with their brand names include:

  • Isocarboxazid (Marplan)
  • Phenelzine (Nardil)
  • Selegiline (Emsam)
  • Tranylcypromine (Parnate)

“The best antidepressants for TMJ patients are the ones that do not cause jaw clenching, as clenching can seriously aggravate TMJ disorders. Because tricyclic antidepressants also help with chronic pain, drugs in this class are sometimes the best alternative to SSRIs if they are causing jaw clenching”, explains Bradly Eli, DMD, MS, an orofacial pain specialist. Please note that any medication changes should be directed by a healthcare professional.

Why Do SSRIs Cause Jaw Clenching?

The mechanisms between SSRIs and jaw clenching are poorly understood. Serotonin, norepinephrine, and dopamine are all neurotransmitters that determine your mood.  Antidepressant drugs like SSRIs and SNRIs try to improve depression or anxiety disorders by altering the levels of these neurotransmitters in your brain.

The problem is that beyond affecting your mood, these neurotransmitters also facilitate movement. In fact, dysregulation of neurotransmitters like serotonin and dopamine has been implicated in various movement disorders. For instance, several studies have shown that rhythmic jaw movements like bruxism are driven in part by CNS neurotransmitter levels. Other studies are now revealing genetic variants in serotonin and dopamine receptors are associated with sleep bruxism.

How to Get Jaw Pain Relief

Constant jaw clenching can quickly lead to jaw strain, jaw muscle fatigue, and generalized jaw pain. These symptoms need to be taken seriously because acute jaw pain, if untreated, is a major risk factor for developing a chronic TMJ disorder, according to a 2020 report by the National Academy of Sciences.

There are several ways to get jaw pain relief if you have SSRI-related jaw clenching. According to the literature, stopping the SSRI should result in decreased jaw clenching within 3-4 weeks. You can either stop taking antidepressant medications altogether or you can start bridging to a different antidepressant not associated with clenching, like a tricyclic antidepressant. Again, any medication changes, including stopping a medication, is a decision that should be guided by a healthcare professional.

There has also been literature on the use of buspirone (Buspar), a general anxiety medication, because it appears to reduce SSRI-induced bruxism. This has not yet been validated in large studies.

If you have jaw pain from clenching, waiting 3-4 weeks until the clenching stops may put you at risk for developing a chronic TMJ pain disorder.  The good news is that there are a variety of conservative measures that you can take to get jaw pain relief. These include jaw rest, gentle physical therapy exercises for the jaw, hot and cold packs, and an anterior bite guard to prevent further jaw clenching.

All of these measures, including the QuickSplint® custom anterior bite guard, are included as part of the Speed2Treat® Home Healing Kit, a comprehensive self-care approach to jaw pain relief. If you are in pain from jaw clenching, you don’t have to wait 3-4 weeks to get relief.  Get help now with the Speed2Treat® Home Healing Kit.

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