Grinding your Teeth in Depression

We all know about the risk of extrapyramidal symptoms with the use of antipsychotics. A similar risk can also be seen with antidepressants, but this is under-recognized. 

I learned this invaluable lesson while treating a patient with worsening depression, suicidal thoughts, excessive sleep and profound anhedonia. I increased her dose of venlafaxine XR from 75 mg daily to 150 mg daily, as dose optimization is the recommended approach. The next time when she came to see me, after four weeks, her depression was easing off but now she presented with headaches almost daily. A few questions later, it was clear that the aches started at her jaw, with jaw clenching and grinding of the teeth before headaches emerged. She responded well to the addition of buspirone.

That was my first exposure to antidepressant-related bruxism. It sent me on a hunting mode for more evidence, and I and my co-authors ended up conducting a thorough literature review on antidepressant-induced bruxism (1).

Here is my interview in our most recent PEF Coffee Club, where I have answered the following five questions on this topic of Antidepressants Induced Bruxism:

  1. What is bruxism & why is bruxism recognition important?
  2. What is the underlying mechanism?
  3. Which antidepressants can increase the risk?
  4. Who is at high risk of developing bruxism with antidepressants?
  5. Management strategies for antidepressants induced bruxism.
These questions will be answered in our following
Two Coffee Club Discussions:

Antidepressants Induced Bruxism


  • This will answer the first three questions and is available for a free preview.

Antidepressants Induced Bruxism


  • This will answer the last two questions and is available for Physician’s Guide for Clinical Psychiatry course subscribers only (read details below):
  1. Singh H, Kaur S, Shah A. Antidepressant induced bruxism: a literature review. Journal of Psychiatric Intensive Care. 2019 Apr 1;15(1):37-44. (article)



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