User talk:JoeGabriell/Bruxism

Thank you very much for your page on bruxism and medications/supplements that exacerbate and ameliorate bruxism. I have a 27 year h/o taking ADs and there is no doubt in my mind that ADs of the SSRI and NRI classes exacerbate bruxism. I was originally put on a TCA (imipramine) at age 20. My depression returned after a few years on the TCA, and in retrospect I realize now that my bruxism began (and was diagnosed) after an SSRI adjunct (paroxetine/Paxil) was added to the TCA in my mid-20s. Over the years I was put on other SSRI or NRI/SNRI meds (venlafaxine/Effexor, escitalopram/Lexapro, bupropion/Wellbutrin) as I cycled through meds that stopped working. On these meds my bruxism was clearly worse; I even broke my mouthguard at one point.

In my 30s I was diagnosed with ADD along with depression and also put on Adderall simultaneously with bupropion. The bruxism worsened severely at that point (I was also on bupropion simultaneously). But since Adderall also raised my systolic (160s-170s) and diastolic (>100) blood pressure, I was quickly taken off Adderall. My bruxism was reduced, however, when I was diagnosed with myofascial pain syndrome/fibromyalgia and was puton nortriptyline for chronic pain syndrome and interrupted sleep.

Dental work, whether routine exam/cleaning or new fillings/repair of cracked teeth/fillings, ALWAYS exacerbates my bruxism for days or weeks afterward.

Two additional notes: (1) I have found a few research articles describing exacerbation of bruxism by the use of mouth guards. In my experience this seems to be true, regardless of medications -- the more continuously I wear my mouth guard, the more I seem to clench &/or grind in my sleep. (I have not been in any sleep studies that confirm this, as for the last few years I have had either no insurance or limited insurance which would not pay for sleep studies -- this is based on my observation of worsened symptoms/facial-head-neck muscle tension/headaches upon awakening in the morning.)

(2) A recent case report1 and a comment to it2 suggest hydroxyzine as effective in treating pediatric bruxism. The comment discusses the possibility that mechanism of action is the antidopaminergic action of H1 class inverse agonists. While anecdotal, these suggest that other first generation H1 inverse agonists (first generation antihistamines) may be useful in treating bruxism pharmacologically.

This is especially exciting to me, as many of the first generation H1 inverse agonists (such as diphenhydramine/Benadryl, meclizine/Bonine, and doxylamine/UniSom) are available as non-prescription, OTC (over the counter) medications for allergies, motion sickness, and insomnia (respectively) in North American drugstores -- at relatively cheap prices.

1. Treatment of bruxism with hydroxyzine. Ghanizadeh A. Eur Rev Med Pharmacol Sci. 2013 Mar;17(6):839-41. PMID: 23609369

2. Treatment of bruxism with hydroxyzine: a possible mechanism of action. Kucuk U, Olgun Kucuk H, Deniz S, Balta S. Eur Rev Med Pharmacol Sci. 2013 May;17(9):1278. No abstract available. PMID: 23690201