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SSRI-associated nocturnal bruxism in four patients
1Department of Psychiatry, Tufts/New England Medical Center, Boston, Mass. 02111.
Background:
Nocturnal bruxism (tooth clenching and/or grinding during sleep) affects a significant proportion of the population. Its etiology remains uncertain, and no entirely satisfactory treatment is available.
Method:
This is an observational report of four depressed individuals selected from one psychiatrist's practice within an urban hospital's psychopharmacology clinic. Psychiatric diagnoses were made according to DSM-III-R criteria. Nocturnal bruxism was determined on the basis of dental examination and/or self-reported nocturnal tooth clenching and/or grinding.
Results:
Four patients developed nocturnal bruxism within 2 to 4 weeks after initiation of treatment with fluoxetine or sertraline. Bruxism remitted in all patients after a decrease in antidepressant dosage (N = 1) or addition of buspirone (N = 3).
Conclusion:
These observations, which should be confirmed by a controlled study, suggest an association between serotonin selective reuptake inhibitor (SSRI) treatment and the onset or exacerbation of nocturnal bruxism. In addition, they suggest that a decrease in SSRI dosage or the addition of buspirone may relieve SSRI-associated nocturnal bruxism.