Does Pristiq cause bruxism? (+3 factors)

In this article, we will discuss whether pristiq causes bruxism. We will delve into what research tells us about the factors contributing to bruxism while taking Pristiq. Additionally, we will provide some beneficial tips to help you deal with bruxism. 

Does Pristiq cause bruxism? 

Yes, bruxism can be a potential side effect of Pristiq for some individuals (1). However, it might not be common for everyone who takes Prestiq to experience bruxism. Pristiq is an antidepressant.

It is a selective serotonin-norepinephrine reuptake inhibitor (SNRI). It works by increasing the levels of certain chemicals in the brain that are important for mood and pain control. Bruxism is an involuntary clenching or grinding of teeth. In individuals taking antidepressants like Pristiq, bruxism is estimated to occur in approximately 10-20% of adults.

Bruxism typically develops within 3-4 weeks of starting Pristiq. Symptoms usually resolve within 3-4 weeks of stopping Pristiq and switching medications or adding other medication like buspirone. It’s essential to communicate any concerns promptly with your healthcare provider to ensure appropriate care and management of side effects.

What does research suggest? 

Research studies suggest that bruxism occurs in a subset of people taking antidepressants including Pristiq, estimated to be around 10-20% of adults on medications (2).

A 35-year-old male diagnosed with depression was prescribed Prestiq. After 3 weeks on Prestiq, the patient repeated clenching and grinding teeth during sleep. The symptoms persisted for 4 weeks until a medication switch to an alternative antidepressant led to bruxism within the following 2 weeks. 

A 42-year-old female undergoing treatment for anxiety with Pristiq. Within the first month, the patient experienced nocturnal teeth grinding along with jaw discomfort. The healthcare provider introduced Buspirone as an adjunct medication, resulting in the gradual alleviation of bruxism symptoms over 6 weeks.

These cases demonstrate different occurrences of bruxism linked to Pristiq use and the range of methods employed by healthcare providers to address and alleviate these symptoms.

What are the factors contributing to bruxism while taking Pristiq? 

Some factors contribute to bruxism while taking Prestiq as follows (3): 

Stress and Anxiety 

Bruxism is often linked to stress and anxiety. The overwhelming pressure and tension can inadvertently transfer to clenching or grinding teeth, particularly during sleep. Stress management techniques like meditation, exercise, or therapy can significantly alleviate bruxism.


Medications like Prozac, Paxil, Zoloft, and Pristiq have been associated with bruxism in some patients. Changes in neurotransmitter levels particularly serotonin and nor-epinephrine can impact muscle tension and potentially lead to teeth grinding.

Sleep Disorders 

Interruptions in sleep or nightmares caused by Pristiq can trigger involuntary muscle movements, potentially leading to bruxism episodes during the night. Monitoring sleep patterns and discussing any disturbances with a healthcare provider while taking Pristiq can aid in understanding and managing associated bruxism.

Genetic Predisposition 

Variations in genes related to muscle function and neurotransmitter regulation could influence the likelihood of developing bruxism. Certain individuals might inherit a susceptibility to teeth-grinding from their parents or family lineage.


Smoking often leads to dry mouth due to decreased saliva production, potentially exacerbating the risk of bruxism. The lack of sufficient saliva can contribute to oral discomfort and altered mouth pH, creating conditions conducive to teeth grinding.

What are the symptomatic management of bruxism? 

Here are general strategies healthcare providers might suggest: 

Pain Management 

For conditions causing pain, healthcare providers might recommend over-the-counter OTC pain relievers like acetaminophen (Tylenol), ibuprofen (Advil), or naproxen (Aleve). It’s generally a safe option when used as directed.

Healthcare providers might suggest topical treatments like creams, gels, or patches containing lidocaine, capsaicin, or NSAIDs for localized pain relief. In cases, where bruxism is associated with temporomandibular joint (TMJ) disorders or severe jaw muscle inflammation, healthcare providers might consider short-term localized injection of triamcinolone acetonide which can be directly injected into affected muscles to reduce inflammation and temporarily relieve symptoms.

Oral Applications or Splints 

Oral appliances like mouthguards and splints offer a physical barrier between teeth to mitigate the effects of bruxism. Custom-fit devices are tailored by dentists to suit the individual’s mouth structure providing a cushion against grinding forces.

They not only shield teeth but also alleviate jaw tension and muscle strain. Regular adjustment and monitoring by dental professionals ensure their effectiveness over time.

Cognitive Behavioral Approaches (CBT)

This method targets the psychological trigger behind bruxism. Cognitive behavioural therapy (CBT) serves as a powerful tool not only for managing the physical act of grinding but in empowering individuals to regain control over their responses to stress ultimately easing the burden of both mind and teeth.

Additionally, modalities like heat therapy or ultrasound may be utilized to ease muscle tension, promoting relaxation and reducing bruxism-related discomfort. If changing the dosage and managing symptoms don’t help with bruxism buspirone could be prescribed if adjusting antidepressants doesn’t address teeth grinding.

What are the pharmacological approaches to manage bruxism?

As for the management of bruxism, there are several approaches which are as follows:

Muscle Relaxants 

Benzodiazepines such as clonazepam or diazepam can help to relax muscles and reduce anxiety. They might be prescribed for short-term relief especially if stress or anxiety exacerbates bruxism.

 Selective Serotonin Reuptake Inhibitors (SSRIs)

SSRIs (Selective Serotonin Reuptake Inhibitors ) such as amitriptyline primarily increase serotonin levels in the brain which can indirectly influence muscle tone and pain perception.SSRIs can paradoxically worsen bruxism in some patients so careful monitoring is crucial.

Tricyclic Antidepressants (TCAs)

Tricyclic antidepressants such as clomipramine block the reuptake of neurotransmitters (serotonin and norepinephrine) which might alleviate bruxism symptoms through their muscle relaxant and pain-relieving properties. They also require more cautious monitoring due to potential drug interactions. 

Dopamine Agonist 

Dopamine agonists are a class of drugs that mimic the effects of dopamine in the brain. A low dose of pergolide a dopamine-modulating drug has been reported to be effective for the suppression of severe bruxism.

Botulinum toxin(BoNT-A) Injections

Botulinum Toxin (B0NT-A) injections meticulously administrated into targeted jaw muscles like masseter and temporalis muscles interrupt the nerve signals triggering intense muscle contractions associated with bruxism.BoNT-A helps to reduce the intensity and frequency of involuntary jaw movements.

Dosage adjustments

For a medication like Pristiq, the dosage should be carefully monitored and adjusted based on patients’ responses and side effects. Regular follow-ups with the doctor are essential to assess the effectiveness of the chosen treatment and make any necessary dosage adjustments. 

Add-on treatments

Since stress is a common exacerbating factor for bruxism, stress reduction strategies such as exercise, meditation or counselling may be beneficial. 

Also improving sleep quality through good sleep hygiene practices may help reduce bruxism episodes. For some individuals, physical therapy may be effective in addressing muscle tension and promoting relaxation. 

What are alternative medications for bruxism caused by Pristiq?

If you are experiencing bruxism while taking Pristiq, consult your doctor. He may suggest several alternative medications that may offer a lower risk of this side effect. Here are some potential alternatives are:

Selective serotonin reuptake inhibitors (SSRIs ) 

  • Fluoxetine (Prozac) 
  • Sertraline (Zoloft) 
  • Citalopram (Celexa) 

Serotonin-norepinephrine reuptake inhibitors (SNRIs)

  • Venlafaxine (Effexor) 
  • Duloxetine (Cymbalta)  

Tricyclic Antidepressant (TCAs) 

  • Amitriptyline ( Elavil ) 
  • Nortriptyline (Pamelor)

Atypical Antidepressants 

  • Bupropion (Wellbutrin ) 
  • Mirtazapine(Remeron) 

Alternative Therapeutic Approaches 

  • Cognitive behavioural therapy (CBT)
  • Lifestyle changes 

In my opinion, Bruxism can occur as a side effect of certain medications including Pristiq its direct association with this specific antidepressant may vary from person to person. Consult your healthcare provider immediately if you have bruxism after taking Pristiq.

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Cockburn N, Pradhan A, Taing MW, Kisely S, Ford PJ. Oral health impacts of medications used to treat mental illness. Journal of affective disorders. 2017 Dec 1;223:184-93.Available from:


Sarkar S, Saha I, Sarkar T, et al. Dentistry and oral health in anxiety-inducing situations during coronavirus disease 2019: A review. Journal of Oral and Maxillofacial Pathology. 2018;22(Suppl 1):S11-S17. doi:10.4103/jomfp.JOMFP_185_18.Available from:

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