BiteStrip analysis of the effect of fluoxetine and paroxetine on sleep bruxism

- This study showed that SSRIs (paroxetine, fluoxetine) may initiate or aggravate SB.
- Psychiatrists and dentists who have to treat bruxism should be able to recognize the possible side effect of these drugs.
- Knowledge of the possible adverse effects of SSRIs is vital to prevent potentially significant patient morbidity.

ObjectiveThe relationship between sleep bruxism (SB) and selective serotonin reuptake inhibitors (SSRIs) is still under debate because of the lack of well-designed objective studies. The current study investigates possible effects of SSRIs, fluoxetine, and paroxetine on SB in patients with anxiety and depression.Materials and methodsThirty users of SSRIs for treatment of depression or anxiety were enrolled in the study. After clinical and anamnestic examination, 15 fluoxetine and 15 paroxetine users were included. For an objective evaluation of SB, a single-use disposable home screening device, BiteStrip, was used prior to the first SSRI intake and was repeated on the 7th and 15th days. Patients' self-reported data also were obtained for assessment of patient awareness.ResultsBiteStrip scores were significantly higher on the 7th and 15th days than the first measurement (p < 0.01). There was an increase in 26 (86.6%) patients' bruxism scores on the 7th day. There was also an increase in 27 (90%) patients' bruxism scores on the 15th day. But according to patients' self-reports, only 6 patients had an awareness that bruxism symptoms were initiated or exacerbated 15 days after starting fluoxetine or paroxetine.ConclusionFluoxetine and paroxetine, SSRIs used for the treatment of anxiety and depression, may initiate or aggravate SB. Clinicians should consider that SSRIs may be the cause of SB when SSRI users are referred to dental clinics for SB symptoms. As there is a shortage of researches on this subject, further studies are necessary to confirm the existence of SSRI-induced SB.