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Re: ssri/snri induced bruxism: what didn't help

Posted by linkadge on August 13, 2007, at 22:27:52

In reply to Re: ssri/snri induced bruxism: what didn't help, posted by Phillipa on August 13, 2007, at 16:47:53

>My biggest problem is chest pain and panic >attacks, so that would be useless.

Have you considered a beta blocker with a benzodiazapine? Beta blockers have some effect in GAD, and can be especially usefull if you have tremor or cardiac issues.

You could, like phillipa mentioned, try Remeron. There are some studies suggesting potential anti-panic effects. It does affect serotonin but in a less forcefull way than the SSRI's. It also blocks certain serotonin receptors which can reduce akathesia.

I have a jaw joint disorder that may require surgical intervention. The SSRI's absolutely caused nasty jaw clenching, although this side effect significantly lessened over the course of a few months. It may be possable to take lower doses to start untill this side effect diminshes.

The jaw clenching is probably due to the initial serotonergically mediated inhibition on dopamine release. The brain does adapt somewhat to this effect. It did for me. Just something to consider.

>Meanwhile, I have purchased a nightguard (today) >and take Advil for the jaw pain. I can't stop >crying and still have anxiety. So, I don't know >what will happen next but you all understand >that this is not a good quality of life and that >I don't plan on having to live with this my >whole life, and go to school (law), and take >care of my family, and do everything I have to >do to pay off my mortgage and school loans.

Sounds like you've got a lot on your plate. Medications can help but they do have limitations.

I hope you can find the ballance in your life that you need.

The MAOI's are usefull for panic and GAD, but have side effects of their own. They may also cause jaw clenching.

The TCA's might be worth looking into, at least in low doses. They are effective for panic attacks. They are probably less likely to cause jaw clenching as the anticholinergic effects, and antiserotonin effects (at 5-ht2a/c) can lesson the effect on dopamine.

Doxapin, for instance, produced nowhere near the same level of start up akathesia as the SSRI's for myself. Amitryptaline might be worth a shot.

>I have also tried CBT and meditation...nothing >has worked. I have lost all hope.

Don't loose hope. There are options. I wouldn't put all your hope in meds, they are only one tool in the box.

Linkadge



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poster:linkadge thread:776019
URL: http://www.dr-bob.org/babble/20070808/msgs/776124.html