Does Effexor cause jaw pain? (+1 evidences)

In this article, we will discuss whether Effexor causes jaw pain. Effexor (venlafaxine) is a selective serotonin-norepinephrine reuptake inhibitor (SNRI) indicated in the treatment of depression, panic attacks, and social phobia. 

Does Effexor cause jaw pain?

Yes, Effexor may cause jaw pain. Jaw pain may develop as an adverse reaction to the Effexor treatment. Data suggests that Effexor-induced jaw pain can occur in any age group, even children. The patient might experience jaw clenching, and teeth grinding along with jaw pain.

Symptoms may appear 3-4 weeks after starting Effexor and may disappear 3-4 weeks after discontinuation of the drug (1). Your dentist will diagnose the degree of jaw pain by checking the following:

  • Jaw muscle tenderness,
  • Signs of dental abnormalities, and
  • Damage to the jaw bone, teeth or inside of your cheek by X-ray.

How does Effexor cause jaw pain?

Some physicians believe that Effexor may cause jaw pain indirectly by altering the dopamine levels in the brain. A change in dopamine level alters certain movements, including jaw clenching, which ultimately leads to jaw pain.

Another research stated that Effexor causes dopaminergic deficiency in the ventral tegmental area and increases serotonergic activity in mesocortical neurons. This can eventually cause jaw pain in some of the patients treated with Effexor (2).

Bruxism, another name for tooth grinding, is a widespread disorder that impacts a large number of people. Stress and misaligned teeth are two common reasons for teeth grinding. Recent studies have also connected the use of Effexor to be responsible for teeth grinding and muscle tension in the jaw.

Bruxism is more likely to appear after starting Effexor or during dose titration. It can also occur as an adverse reaction to Effexor therapy. The tense muscles can also cause jaw pain, especially at night (3).

What are the associated symptoms of Effexor-induced jaw pain?

Jaw pain can be induced at any age, irrespective of sex (4). Jaw pain can resolve with time, but might recur later in life. Some associated symptoms might also include

  • jaw clenching,
  • teeth grinding,
  • gum bleeding,
  • pain in the neck and face,
  • difficulty in speaking,
  • sleep abnormalities.

The patient suffering from Effexor-induced jaw pain can be at high risk of developing a chronic temporomandibular joint (TMJ) pain disorder.

What does research suggest?

One cross-sectional study compared sleep-induced jaw pain among patients receiving serotonergic antidepressants to control. The overall jaw pain was higher in patients taking Effexor (24.3%) as compared to the control group.

The study also found that the majority of the patients experience jaw pain within 4 months of taking Effexor. The authors found no link between sex, employment status, smoking, or marital status with jaw pain induced by Effexor (5).

How to manage Effexor-induced jaw pain non-pharmacologically?

  • Sleep improvement: If jaw pain is aggravated due to sleep, treating sleep-related issues can help relieve the symptoms.
  • Hot and cold packs can temporarily help relieve jaw pain.
  • Physiotherapy: behavioural changes and exercise can help relieve jaw pain.
  • Avoid stimulating substances: avoid taking caffeine, especially in the evening.
  • Good sleep: sleep on time and in a calming environment to reduce the chances of jaw clenching due to sleep deprivation.

How to manage Effexor-induced jaw pain pharmacologically?

  • Dose adjustment: decreasing the dose of Effexor might help to revert the effect. 
  • Muscle relaxant: In some cases, muscle relaxants like methocarbamol can be prescribed to reduce jaw clenching and associated jaw pain.
  • Anxiolytics: The addition of Buspirone in the treatment regimen has been found to alleviate jaw pain associated with Effexor.
  • Sleep-related disorders: if jaw pain and teeth grinding are occurring due to insomnia induced by Effexor, addressing sleep-related disorders can help relieve jaw pain.

Is Effexor safe during an orthodontic treatment?

There are theoretical contradictions in the safe use of Effexor during an orthodontic treatment. One theory suggests that increased serotonin levels associated with Effexor may be a factor in the rise in RANKL (receptor activator of nuclear factor kappa-B ligand)-mediated osteoclast differentiation that leads to a reduction in bone density.

As a result, the teeth may experience improved orthodontic movement without causing much jaw pain. However, the other theory suggests that the anti-inflammatory effect of antidepressants may cause depression on inflammatory mediators, which would reduce the mobility of teeth in orthodontics and cause jaw pain due to pressure (6).

It is therefore advisable to consult the dentist and inform him about the use of Effexor before proceeding to the orthodontic treatment. 

What is the effect of Effexor on bone health?

Serotonin reuptake receptors are also found in the bone cells. Research has indicated that Effexor may reduce the production of new bone because it raises the levels of extracellular serotonin in bone cells. As the peripherally generated serotonin limits bone production, it has a detrimental effect on bone mass and jaw pain (7).

When to consult the physician?

Effexor-induced jaw pain is an underreported condition. The degree of jaw pain may differ in individuals due to the severity of the disease, increased hostility, and stress sensitivity. Any side effects, including jaw pain, should be reported to the physician immediately. 

The efficacy of the symptomatic treatment varies from person to person and only the physician can establish what is a suitable course of treatment for jaw pain. If the jaw pain persists for a longer period, the physician might consider changing the antidepressant for the treatment of depression. Do not discontinue Effexor at once, as it may cause withdrawal symptoms.

Conclusion

In this article, we discussed the jaw pain induced by Effexor. We also discussed how you can manage jaw pain during the treatment of depression with Effexor. I would recommend visiting your dentist regularly for early detection of any abnormalities.

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References

1.-

Teoh L, Moses G, Duma SR, Fung VS. Drug-induced bruxism. Australian Prescriber. 2019 Aug 1;42. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6698238/?report=classic

2.-

Ak M, Gulsun M, Uzun O, Gumus HO. Bruxism associated with serotonin reuptake inhibitors: two cases. Journal of clinical psychopharmacology. 2009 Dec 1;29(6):620-2. https://journals.lww.com/psychopharmacology/FullText/2009/12000/Bruxism_Associated_With_Serotonin_Reuptake.27.aspx

3.-

Garrett AR, Hawley JS. SSRI-associated bruxism: A systematic review of published case reports. Neurology: Clinical Practice. 2018 Apr 1;8(2):135-41. https://cp.neurology.org/content/8/2/135.abstract

4.-

Shetty S, Pitti V, Satish Babu CL, Surendra Kumar GP, Deepthi BC. Bruxism: a literature review. The Journal of Indian prosthodontic society. 2010 Sep;10:141-8. https://link.springer.com/article/10.1007/s13191-011-0041-5

5.-

Uca AU, Uguz F, Kozak HH, Gümüs H, Aksoy F, Seyithanoglu A, Kurt HG. Antidepressant-induced sleep bruxism: prevalence, incidence, and related factors. Clinical neuropharmacology. 2015 Nov 1;38(6):227-30. https://journals.lww.com/clinicalneuropharm/Fulltext/2015/11000/Antidepressant_Induced_Sleep_Bruxism__Prevalence,.2.aspx

6.-

Yıldırım G, Eralp FE. Effect of Antidepressants and its Orthodontic Implications. https://essentdent.org/Content/files/sayilar/1/12-16.pdf

7.-

Ducy P, Karsenty G. The two faces of serotonin in bone biology. Journal of Cell Biology. 2010 Oct 4;191(1):7-13. https://rupress.org/jcb/article/191/1/7/35980/The-two-faces-of-serotonin-in-bone-biologyDual

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