The Tooth Fairy

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November 20, 2014 | 10 Comments


  1. I was under stress, under psych treatment and under the influence of various drugs for several years, but had no sign of tooth-grinding. Then I got put on Venlafaxine (Effexor).

    Within a few months I was having my first molar pulled … it had cracked straight down the middle so no root-canal could save it. “You’ve been grinding your teeth at night,” said the dentist. “The wear marks are unmistakable.” I told him I’d been going to dentists since I was a kid, and none had ever told me I grind my teeth. “Well, now you do,” he said.

    “Well, now you do” became a sort of theme song for the next two years. Soon I had “migraines” for the first time, with dizziness and vomiting, for which I was served Depakote. Then a new case of “restless legs syndrome”, although only when sleeping. Try Requip! I began clenching my teeth when awake; clenching my fists at times as well. Another molar cracked and had to be pulled. Then another. I began yawning prodigiously, but put that down to the lack of sleep.

    Finally a cranky boss with a few issues of his own took me to task for the yawning, which he thought was a sign of disrespect. I mentioned this in passing to my shrink – as an example of all the stress that boss was causing me. He was surprisingly concerned. It turned out this was clearly an Effexor side effect and a sign of worsening “dystonias” along with the tooth-grinding. He showed me a case report about a guy on Effexor who yawned so hard he dislocated his jaw.

    He took me off the Effexor. The yawning and tooth-grinding died down, and the so-called migraines disappeared entirely. The symptoms were absolutely drug-related … but without Cranky Boss, I might never have known.

    • I used to yawn all the time on Paroxetine but not on Citalopram and I used to grind my teeth on both. I have just as it happens been to the dentist today to have two teeth refilled and the dentist commented on a loose tooth to keep an eye on. I know my teeth have weakened considerably since being on medication. The dentist also told me a tooth implant would cost probably around £2000.

    • It is interesting you mention the yawning, because I have had bouts of yawning on Effexor. I know I have clenched my teeth at night before Effexor because I had gum loss prior which was due to bone loss. Well, after Effexor, I am at 50% bone loss with severe gum recession. I have a mouth guard now, have for a few years, but no dentist prior to this last one recommended one, and I am peeved about that because there’s no getting that bone back! I have been tapering off the Effexor for the last three years, very slowly because I had a very bad protracted withdrawal from trying to come off of it too fast.

  2. In my experience, citalopram is the one for bruxism, no doubt about it. Never caused me a problem as far as I know, but is definitely one of the effects. Another definite effect of citalopram is sweating, ridiculous amounts of sweating. Probably the body trying to rid itself, in anyway it can, of the poison which citalopram is. Once you start sweating, you just can’t stop, never known anything like it.

    As far as alcohol goes, for me, citalopram was the one that made me drink like a fish. The drug makes you so very sociable, you like everyone and you think everyone likes you and if drinking is your social norm, then consumption and pub attendance goes through the roof, together with the amount of generous rounds you buy for all your new found best friends!

    Worryingly, the carefree feeling the drug creates, can wipe out all your usual good sense and even, moral judgement. This for me, among other things, led to habitual drink driving. SSRIs in general, seem to remove one’s impulse control, or natural reserve. This can be a positive thing, but can also be very negative. If circumstances are such that you feel angered towards someone, or you feel tempted by doing something exciting, but immoral, before you know it you’ve just gone on and done it, without a care in the world. The drug is completely mind warping and character warping and getting back to who you were before, is a difficult and quite possibly endless, road.

  3. Both these issues (tooth decay and grinding) are really well-recognized … for street drugs.

    Back at the height of the 1990’s “rave” scene, users of Ecstasy were making pacifiers and lollipops a fashion statement. The pops helped with the dry mouth, the pacifiers when you started clenching your teeth. As for crystal meth, the media and law enforcement always talk about “meth mouth” — the rotted, discolored teeth addicts get after awhile.

    The same goes for Adderall, the prescription amphetamine combo prescribed for ADHD. Funny how the doctor won’t know about that. But at, one of the first articles they posted was “How to get your teeth fixed in Mexico” (for those who couldn’t afford the work at US prices):

  4. JonathanR1981 ‏@JonathanR1981 19h19 hours ago
    @DrDavidHealy I had 2 cracked molars after one year on Celexa. Took it for 10 years, never made the connection.

    Professor Helen ‏@MonsterYarn 5h5 hours ago
    @Gurdur @DrDavidHealy I’m off to the dentist in an hour to discuss my nocturnal teeth grinding on 100mg Sertraline #SSRI

  5. 1993 – Zoloft RX for FATIGUE, absolutely no depression. It was one of the best times of my life. Severe jaw, head, neck pain and muscle tightness across shoulders, front of neck, sometimes down back. Did not relate to bruxism until several months later.
    No idea it was related to Zoloft.
    Sought treatment for pain and TMJ. Was treated by several orofacial pain specialists, including Scripps and Cedars Sinai. An orthodontist had me wear both upper and lower splints 24/7 for months to a year. Made my (pHARMa) sales job extremely difficult. Became depressed due to pain.
    1995 – Still thinking the pain started in neck and went up to jaw, conclusion drawn that it began with carrying new 12# laptop over shoulder all day for job. Doctor said it would be fraudulent to not file thru Work Comp insurance and the true ugliness began.
    Constant appointments w chiros, PT, dentists, neurologists, psychologists, ATTORNEYS and their doctors. Depositions.
    1995 – still not aware of SSRI involvement, doctor RX Klonopin qhs for bruxism, but now, 20 years later, I’m stuck on it.
    Increasing pain meds over the years until on oxycodone and fentanyl.
    Worked until 2001 when I was put on short term medical leave. Despite stellar performance, the company said they could not hold my position and was placed on Involuntary Medical Retirement at age 39. Felt like I was fired and could never work again. I did get significantly better in 2008-10 and almost secured a few positions back in Pharma (still drinking the Koolaid). Became extremely lost, purposeless. My life collapsed, lost many friends, support system (thru work). I never considered that I might not be able to work. No family.
    Work comp lawsuit settled in 2004 for ~$70,000. (11 year process) Disability income of half my salary.
    2006 – lost house in market collapse, husband lost job. Severe depression led me to seek out Intensive Outpatient Program to try to establish routine, get out of house. BAD choice. They put me on every possible drug combo for “treatment resistant depression” (cold switches) never addressing the psychosocial and career issues.
    Continued to get worse with panic attacks upon wakening, uncontrollable crying and anxiety (never had anxiety previously. Situational/event stress only). Realize now it was classic withdrawal.

    Hospital claimed that the psych drugs could not work due to interference at mu receptor by pain meds. Pain docs disagreed, have many people on both. Coerced me into detox. CTd oxycodone (1 pill per day), fentanyl, Klonopin upon admission. Could not use Suboxone due to university rule.
    I left AMA at 3 days with warning from Medical Director that I’d be dead by 48. (I’m 53)
    Went back to regular interventional pain doc who’d treated me for 10 years, never problems w addictive behaviors…had weaned on my own before detox horror. He gave me Suboxone and I was off all opiates in a few weeks. Used CHIRO and acupuncture for pain.
    Returned to old psychiatrist (I had moved) who got me stabilized using Vyvanse while on Pristiq. Ss/NRIs never helped me, ever. He admitted they are depressogenic to some people and went the “dopamine ADD” route. It pulled me out of withdrawal/ depression completely. NOT suggesting to anyone!

    2010- tapered off Pristiq over 10 months, thinking I didn’t need it w Vyvanse. Not severe immediate withdrawal (panic awakenings, no zaps, good energy and mood). After about 9 months, I lost doctor, was unable to find someone to prescribe Vyvanse and CTd. Crashed into hopelessness, apathy, SI. protracted SNRI withdrawal or Vyvanse..? Prob both?

    2012 – got very desperate. Was DX w several AI, endocrine and neuro conditions that appeared upon withdrawal. Hospitalized for bradycardia, pacemaker suggested.
    Was given Fetzima by psych. Didn’t take until late 2014. Pulled up heart rate and BP to normal. No change in mood.

    About 3 months on 20mg, the bruxism and severe pain kicked it. Nothing is helping.
    Consultation w movement disorder self proclaimed “guru” for problems w dopamine system. He suggested botox for TMJ. Mood still very bad (hopeless, akathisia, inability to focus/concentrate, apathy, no purpose) and now more pain and very difficult time tapering Fetzima. I knew better than to ever take another serotonin drug, yet desperation won.

    Also, the university doc did genetic testing that showed SERT genetic polymorphism (“oh, youre right, you can’t process SS/NRIs” but still wants me to try). Also, ultrarapid metabolizer at CYP2D6.

    Sorry so long. It’s been 22 continuous years on a cocktail.

    • I’m sorry to hear all the problems you’ve had but I identified with a lot of it.. misdiagnosis repeatedly, over a dozen specialists never mind the regular pain, gp, chiros, etc., I’m also an ultrarapid metabolizer, which I thought before testing (most have no caffeine effect). I’ve been grinding since I’ve five, but it wasn’t diagnosed as part of the chronic pain condition (myofascial pain), last month I just had an epiphany when doctors told me it’s not normal to complain about having more pain when you wake I hate sleeping because it’s worse… especially since I take muscle relaxers for a sleep disorder so I’m knocked out instead of sleep walking.. it’s a long story but have you tried the botox for bruxism? I’m looking into it but it’s hard to find the right Dr. I started taking magnesium citrate as well as it has been known to help. best wishes, Teri, NJ

  6. I have had to wear a nightguard for years because of intense teeth grinding. I’m also having a problem where 6 six months when I go to the dentist I have a bunch of cavities. I went today and I have 6! The dentist said today she thinks it’s all of the medicine I am on (that I can’t get off of despite tortured trying)–that it’s making my mouth dry and making me more prone to cavitities.

  7. Clarification: I go to the dentist every 6 months for cleaning. Today when I went I had 6 cavities and this keeps happening.

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