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wookie

An AD that doesn't trigger jaw clenching and anxiety

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Going to see my family doctor to see if I can try something else.  Zoloft makes my jaw and neck hurt from clenching.

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Citalopram/Celexa worked the best for me when I had anxiety, it is much less activating than others.

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I never had jaw clenching issues with Lexapro during the day, but I was definitely grinding my teeth at night on both Celexa and Lexapro. My jaw would sometimes feel sore in the morning.

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Anything serotonergic will likely cause jaw clenching. It's in the list of side effects of pretty much every SSRI and SNRI. I second getting a mouth guard to wear when your clenching gets bad. I also second a muscle relaxant. My dentist prescribed me cyclobenzaprine for my TMDD, which helped, but made me depressed, so I can't take it. Skelaxin is probably the best-tolerated muscle relaxant out there, at least for me. A benzo with muscle relaxant properties like Valium might actually be better. 

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I've gone up in dose and feel better. less clenchy.  I found cipralex citalopram very activating,

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On 15-10-2017 at 2:16 PM, mikl_pls said:

Anything serotonergic will likely cause jaw clenching. It's in the list of side effects of pretty much every SSRI and SNRI. I second getting a mouth guard to wear when your clenching gets bad. I also second a muscle relaxant. My dentist prescribed me cyclobenzaprine for my TMDD, which helped, but made me depressed, so I can't take it. Skelaxin is probably the best-tolerated muscle relaxant out there, at least for me. A benzo with muscle relaxant properties like Valium might actually be better. 

I'm dealing with SSRI-induced Restless Legs Syndrome as well as teeth grinding and jaw clenching (or biting on the inside of my cheek. I don't know which one is more annoying.
Is a dopamine agonist going to help? And what about Buspar?

Buspirone is an agonist of the 5-HT1A receptor that increases dopaminergic neuron firing in the ventral tegmental area and increases the synaptic release of dopamine in the prefrontal cortex. These effects ameliorate drug-induced bruxism. Buspirone can also ameliorate extrapyramidal side effects, such as akathisia and tardive dyskinesia, and this property may be an additional explanation for the bruxism-related effects of the drug (5).
from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3275112/ 

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5 hours ago, Catwoman said:

I'm dealing with SSRI-induced Restless Legs Syndrome as well as teeth grinding and jaw clenching (or biting on the inside of my cheek. I don't know which one is more annoying.
Is a dopamine agonist going to help? And what about Buspar?

Buspirone is an agonist of the 5-HT1A receptor that increases dopaminergic neuron firing in the ventral tegmental area and increases the synaptic release of dopamine in the prefrontal cortex. These effects ameliorate drug-induced bruxism. Buspirone can also ameliorate extrapyramidal side effects, such as akathisia and tardive dyskinesia, and this property may be an additional explanation for the bruxism-related effects of the drug (5).
from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3275112/ 

What all are you taking now? Just Zoloft and Buspar?

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12 hours ago, Catwoman said:

I'm dealing with SSRI-induced Restless Legs Syndrome as well as teeth grinding and jaw clenching (or biting on the inside of my cheek. I don't know which one is more annoying.
Is a dopamine agonist going to help? And what about Buspar?

Buspirone is an agonist of the 5-HT1A receptor that increases dopaminergic neuron firing in the ventral tegmental area and increases the synaptic release of dopamine in the prefrontal cortex. These effects ameliorate drug-induced bruxism. Buspirone can also ameliorate extrapyramidal side effects, such as akathisia and tardive dyskinesia, and this property may be an additional explanation for the bruxism-related effects of the drug (5).
from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3275112/ 

A dopamine agonist might help.

Buspirone also antagonizes the presynaptic dopamine autoreceptors which causes dopamine release.

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13 hours ago, browri said:

What all are you taking now? Just Zoloft and Buspar?

I'm taking Luvox now. Today I'm at 5 weeks. Last week I increased to 150 mg.
It's not working like in the old days, so I'm wondering what will get it working again and if there's something to help against the jaw clenching, teeth grinding and restless legs.

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Yeah Buspar should theoretically help bruxism based on some studies. It may help with the restless legs or it could make them worse because some people find Buspar to be activating. The other option would be to add a low dose antipsychotic which may calm it down a bit.

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59 minutes ago, browri said:

Yeah Buspar should theoretically help bruxism based on some studies. It may help with the restless legs or it could make them worse because some people find Buspar to be activating. The other option would be to add a low dose antipsychotic which may calm it down a bit.

I hope I can find something activating. Especially in the mornings I feel kind of down and slow.  When I was on Zoloft I didn't notice anything special and I was sleeping fine.
 

Edited by Catwoman

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8 minutes ago, Catwoman said:

I hope I can find something activating. Especially in the mornings I feel kind of down and slow.  When I was on Zoloft I didn't notice anything special and I was sleeping fine.
 

The tricky thing with activating medications is that they can make your teeth grinding worse. I notice that a lot with Vyvanse. While it really pulls me out of a hole and augments Trintellix really well, I do sometime grind my teeth during the day to the point that my jaw is sore and that's really my only complaint. My dentist can notice it too when he's doing my cleanings. Be wary of stimulants if you already have a clenching problem.

EDIT: Actually, now that I say it, perhaps taking something on the more sedating side might help with the clenching. I believe I may have mentioned a fluvoxamine/clomipramine combination to you before. That's always a combination that you could consider. Fluvoxamine can dramatically increase clomipramine levels though. So some psychiatrists would consider this effort heroic. But if fluvoxamine isn't working as well for you this time around as it has in the past, augmenting with lower dose clomipramine would be the way to go. You just have to get blood work done VERY often to ensure your clomipramine levels aren't getting too high.

However, a fluvoxamine/clomipramine combination when used properly would be some of the best treatment that you could possibly get for OCD.

Edited by browri

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The combination of Buspar and Zoloft was not working for me.  I became angry when I missed a buspar dose one day and had a bit of a road rage incident (I just yelled at the guy, but came off as pretty aggressive).  I was also very snappy and angry on this med combo when I took it consistently.

I was clenching badly on this combo as well.  My neck muscles hurt.

Was switched off buspar to Lyrica.  It's pretty experimental but I do feel better and not so angry.  It's making me physically relax.  Plus I have heard it is good for essential tremor (I've read it is a second line of treatment for that).

My sleep still sucks but it's been much much worse pre-meds.

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2 minutes ago, wookie said:

The combination of Buspar and Zoloft was not working for me.  I became angry when I missed a buspar dose one day and had a bit of a road rage incident (I just yelled at the guy, but came off as pretty aggressive).  I was also very snappy and angry on this med combo when I took it consistently.

I was clenching badly on this combo as well.  My neck muscles hurt.

Was switched off buspar to Lyrica.  It's pretty experimental but I do feel better and not so angry.  It's making me physically relax.  Plus I have heard it is good for essential tremor (I've read it is a second line of treatment for that).

My sleep still sucks but it's been much much worse pre-meds.

Most doctors don't read into it too much but Zoloft does have a considerable effect on dopamine, especially at higher doses. This could explain the tension.

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I wonder if I should go down in dose?  I was feeling pretty good at 50 mg but I had only been on the med a week, and thought it might be a placebo effect.  I see a new psych in Feb, and a neurologist March.  

I can go back to Remeron but the weight gain was ridiculous.

Edited by wookie

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1 hour ago, wookie said:

I wonder if I should go down in dose?  I was feeling pretty good at 50 mg but I had only been on the med a week, and thought it might be a placebo effect.  I see a new psych in Feb, and a neurologist March.  

I can go back to Remeron but the weight gain was ridiculous.

I'm bipolar so take this with a grain of salt, but I never needed more than 50mg of Zoloft. 75mg made me agitated and put me in a cold, stony sort of mood.

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