Case Report

Low-Dose Quetiapine in the Treatment of SSRI-Induced Bruxism and Mandibular Dystonia: Case Series

Abstract

Objective: Selective serotonin reuptake inhibitors (SSRIs) have been the most widely used psychopharmacological agents prescribed for depression worldwide. Some adverse effects of SSRI drugs on central nervous system are insomnia and bruxism. These drugs also affect sleep. Quetiapine is used as adjunctive therapy to antidepressants for the treatment of major depressive disorder (MDD). It is a low- dose dibenzothiazepine with more potent 5-HT2 than D2 receptor-blocking properties that can be used to manage bruxism because of its antagonist effect on the 5-HT2 receptor.
Cases: The cases were 5 patients who have recently been treated with SSRIs and presented with bruxism. Low- dose quetiapine (between 25 and 50 mg daily) was prescribed for the patients, and after a few days, they reported no bruxism and continued taking the medication.
Conclusion: We found that quetiapine can improve bruxism and mandibular dystonia, which are side effects of SSRIs.

Sadock BJ. Kaplan and Sadock's Comprehensive Textbook of Psychiatry, 10 eds. Philadphia: Wolters Kluwer Health; 2017.

Sadock BJ. Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry 11 ed. New York: Lippincott Williams & Wilkins; 2015.

Uvais NA, Sreeraj VS, Sathish Kumar SV. Sertraline induced mandibular dystonia and bruxism. J Family Med Prim Care 2016; 5: 882-884.

Raveendranathan D, Rao SG. Sertraline induced acute mandibular dystonia. J Neurosci Rural Pract 2015; 6: 586-587.

Wise M. Citalopram-induced bruxism. Br J Psychiatry 2001; 178: 182.

Ellison JM, Stanziani P. SSRI-associated nocturnal bruxism in four patients. J Clin Psychiatry 1993; 54: 432-434

Milanlıoglu A. Paroxetine-induced severe sleep bruxism successfully treated with buspirone. Clinics 2012; 67: 191-192.

Prisco V, Iannaccone T, Di Grezia G. Use of buspirone in selective serotonin reuptake inhibitor-induced sleep bruxism. European Psychiatry. 2017; 41: S855.

Sabuncuoglu O, Ekıncı O, Berkem M. Fluoxetine‐induced sleep bruxism in an adolescent treated with buspirone: a case report. Spec Care Dentist 2009; 29: 215-217.

Çolak Sivri R, Akça ÖF. Buspirone in the Treatment of Fluoxetine-Induced Sleep Bruxism. Journal of child and adolescent psychopharmacology 2016; 26: 762-763.

Bostwick JM, Jaffee MS. Buspirone as an antidote to SSRI-induced bruxism in 4 cases. J Clin Psychiatry 1999; 60: 857-860.

Arya DK. Extrapyramidal symptoms with selective serotonin reuptake inhibitors. Br J Psychiatry 1994; 165: 728-733.

Benloucif S, Keegan MJ, Galloway MP. Serotonin-facilitated dopamine release in vivo: pharmacological characterization. J Pharmacol Exp Ther 1993; 265: 373-377.

Oulis P, Dimitrakopoulos S, Konstantakopoulos G, Tsaltas E, Kollias K. Low-dose aripiprazole in the treatment of SSRI-induced bruxism. J Neuropsychiatry Clin Neurosci 2012; 24: E39.

Grinshpoon A, Weizman A, Amrami-Weizman A. The beneficial effect of trazodone treatment on escitalopram-associated nocturnal bruxism. J Clin Psychopharmacol 2014; 34: 662.

Brown ES, Hong SC. Antidepressant-induced bruxism successfully treated with gabapentin. The Journal of the American Dental Association 1999; 130: 1467-1469.

Soyata AZ, Oflaz S. Gabapentin treatment in bruxism associated with fluoxetine. J Clin Psychopharmacol 2015; 35:481-3.

Betz A, Ishiwari K, Wisniecki A, Huyn N, Salamone JD. Quetiapine (Seroquel) shows a pattern of behavioral effects similar to the atypical antipsychotics clozapine and olanzapine: studies with tremulous jaw movements in rats. Psychopharmacology (Berl) 2005; 179: 383-392.

Mohapatra S. Successful Management of Tardive Dyskinesia with Quetiapine and Clonazepam in a Patient of Schizophrenia with Type 2 Diabetes Mellitus. Clin Psychopharmacol Neurosci 2016 31; 14: 218-220.

Chow ES, Zangeneh-Kazemi A, Akintan O, Chow-Tung E, Eppel A, Boylan K. Prescribing Practices of Quetiapine for Insomnia at a Tertiary Care Inpatient Child and Adolescent Psychiatry Unit: A Continuous Quality Improvement Project. J Can Acad Child Adolesc Psychiatry 2017; 26: 98-103.

Files
IssueVol 13 No 3 (2018) QRcode
SectionCase Report(s)
Keywords
Bruxism Mandibular Dystonia Quetiapine Serotonin Reuptake Inhibitors (SSRIs)

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
zandifar A, Mohammadi MR, Badrfam R. Low-Dose Quetiapine in the Treatment of SSRI-Induced Bruxism and Mandibular Dystonia: Case Series. Iran J Psychiatry. 2018;13(3):227-229.