Dry mouth prozac: Dental note: Oral and dental effects of antidepressants

08.07.202326.06.2023 by alexxlab

Meta-analysis: Risk of dry mouth with second generation antidepressants

Review

. 2018 Jun 8;84(Pt A):282-293.

doi: 10.1016/j.pnpbp.2017.12.012.

Epub 2017 Dec 20.

Kiley Cappetta¹, Chad Beyer², Jessica A Johnson², Michael H Bloch³

Affiliations

¹ Department of Psychiatry of Yale University, New Haven, CT, United States.
² Yale Child Study Center, New Haven, CT, United States.
³ Yale Child Study Center, New Haven, CT, United States; Department of Psychiatry of Yale University, New Haven, CT, United States. Electronic address: [email protected].

PMID:
29274375
DOI:
10.1016/j.pnpbp.2017.12.012

Review

Kiley Cappetta et al.

Prog Neuropsychopharmacol Biol Psychiatry.

2018.

. 2018 Jun 8;84(Pt A):282-293.

doi: 10.1016/j.pnpbp.2017.12.012.

Epub 2017 Dec 20.

Authors

Kiley Cappetta¹, Chad Beyer², Jessica A Johnson², Michael H Bloch³

Affiliations

¹ Department of Psychiatry of Yale University, New Haven, CT, United States.
² Yale Child Study Center, New Haven, CT, United States.
³ Yale Child Study Center, New Haven, CT, United States; Department of Psychiatry of Yale University, New Haven, CT, United States. Electronic address: [email protected].

PMID:
29274375
DOI:
10.1016/j.pnpbp.2017.12.012

Abstract

Objective:

The goal of this meta-analysis was to quantify the risk of dry mouth associated with commonly prescribed antidepressant agents and examine the potential implications of medication class, dose, and pharmacodynamics and dose on risk of treatment-induced dry mouth.

Data sources and study selection:

A PubMed search was conducted to identify double-blind, randomized, placebo-controlled trials examining the efficacy and tolerability of second generation antidepressant medications for adults with depressive disorders, anxiety disorders, and OCD.

Data extraction:

A random-effects meta-analysis was used to quantify the pooled risk ratio of treatment-emergent dry mouth with second generation antidepressants compared to placebo. Stratified subgroup analysis and meta-regression was utilized to further examine the effects antidepressant agent, class, dosage, indication, and receptor affinity profile on the measured risk of dry mouth.

Results:

99 trials involving 20,868 adults. SNRIs (Relative Risk (RR)=2.24, 95% Confidence Interval (CI): 1. 95-2.58, z=11.2, p<0.001) were associated with a significantly greater risk of dry mouth (test for subgroup differences χ²=7.6, df=1; p=0.006) compared to placebo than SSRIs (RR=1.65, 95% CI: 1.39-1.95, z=5.8, p<0.001). There was a significant difference found in the risk of dry mouth between diagnostic indications within the SNRI class (test for subgroup differences χ²=9.63, df=1; p=0.002). Anxiety diagnoses (RR=2.78, 95% CI: 2.29-3.38, z=10.32, p<0.001) were associated with a greater risk of dry mouth compared to depression (RR=1.80, 95% CI: 1.48-2.18, z=5.85, p<0.001). Decreased affinity for Alpha-1 (PE=0.18, 95% CI: 0.07-0.28, z=3.26, p=0.001) and Alpha-2 (PE=0.49, 95% CI: 0.22-0.75, z=3.64, p<0.001) receptors and SERT (PE=0.07, 95% CI: 0.01-0.14, z=2.10, p<0.05) was significantly associated with increased risk of dry mouth.

Conclusions:

The current meta-analysis suggests that SSRIs, SNRIs, and atypical antidepressants are all associated with varying degrees of increased risk of dry mouth. SNRIs were associated with a significantly greater risk of dry mouth compared to SSRIs.

Keywords:

Dry mouth; Meta-analysis; Second generation antidepressants; Serotonin uptake inhibitors; Xerostomia.

Cited by

Major depression-related factor NEGR1 controls salivary secretion in mouse submandibular glands.
Lee J, Kim S, Lee B, Kim YB, Kim KH, Chung G, Lee SJ, Lee S, Sun W, Park HK, Choi SY.
Lee J, et al.
iScience. 2023 Apr 26;26(5):106773. doi: 10.1016/j.isci.2023.106773. eCollection 2023 May 19.
iScience. 2023.
PMID: 37216094
Free PMC article.
Dry mouth effects from drugs used for depression, anxiety, schizophrenia and bipolar mood disorder in adults: systematic review.
Teoh CXW, Thng M, Lau S, Taing MW, Chaw SY, Siskind D, Kisely S.
Teoh CXW, et al.
BJPsych Open. 2023 Mar 20;9(2):e53. doi: 10.1192/bjo.2023.15.
BJPsych Open. 2023.
PMID: 36938801
Free PMC article.
Review.
Progress in salivary glands: Endocrine glands with immune functions.
Shang YF, Shen YY, Zhang MC, Lv MC, Wang TY, Chen XQ, Lin J.
Shang YF, et al.
Front Endocrinol (Lausanne). 2023 Feb 3;14:1061235. doi: 10.3389/fendo.2023.1061235. eCollection 2023.
Front Endocrinol (Lausanne). 2023.
PMID: 36817607
Free PMC article.
Review.
Natural Products Inhibitors of Monoamine Oxidases-Potential New Drug Leads for Neuroprotection, Neurological Disorders, and Neuroblastoma.
Chaurasiya ND, Leon F, Muhammad I, Tekwani BL.
Chaurasiya ND, et al.
Molecules. 2022 Jul 4;27(13):4297. doi: 10.3390/molecules27134297.
Molecules. 2022.
PMID: 35807542
Free PMC article.
Review.
Salivary Gland Dysfunction Secondary to Cancer Treatment.
Vistoso Monreal A, Polonsky G, Shiboski C, Sankar V, Villa A.
Vistoso Monreal A, et al.
Front Oral Health. 2022 Jun 9;3:907778. doi: 10.3389/froh.2022.907778. eCollection 2022.
Front Oral Health. 2022.
PMID: 35757443
Free PMC article.
Review.

See all “Cited by” articles

Publication types

MeSH terms

Substances

Are Your Anxiety Medications Causing Dry Mouth?

Are Your Anxiety Medications Causing Dry Mouth?Skip to main content< Back to the article list

Do you suffer from anxiety? If you’re one of millions of Americans taking prescription medications to control either acute or chronic anxiety, you may also be experiencing unwanted side effects, such as Dry Mouth. In fact, it is the most commonly reported side effect of psychiatric medications, with an average of 40% of patients complaining of Dry Mouth.

Prescription medication can be an important ally in treating anxiety. Unfortunately, any medication that’s taken systemically (i.e. swallowed and absorbed into the system) can affect your whole body – not just the part it’s meant for. Antianxiety medications are no exception. As someone who’s already anxious, the last thing you want to worry about is Dry Mouth symptoms like bad breath and difficulty speaking.

There are four major classes of medications that can be prescribed to treat anxiety – many of them antidepressants, which are known to have Dry Mouth as a potential side effect. Each class works slightly differently.

Selective serotonin reuptake inhibitors (SSRIs)

SSRIs are antidepressants and mood enhancers, working by enabling more serotonin to be available to the brain. They are commonly prescribed for generalized anxiety. SSRIs can, however, still cause Dry Mouth. Anticholinergics are medications that would block actions of acetylcholine, which is a type of neurotransmitter. This would result in blockage of involuntary muscle movements and various bodily functions. An example of such are typically related to the production of saliva, digestion, urination or movements. SSRIs you might recognize include citalopram, fluoxetine and sertraline.

Serotonin-norepinephrine reuptake inhibitors (SNRIs)

SNRIs work in a similar fashion to SSRIs, with an increase in both serotonin and norepinephrine, in the brain. They may be prescribed as a longer-term treatment for anxiety and have been shown to cause Dry Mouth. SNRIs that are frequently prescribed for anxiety include venlafaxine, desvenlafaxine and duloxetine.

Tricyclic antidepressants (TCAs)

TCAs are the oldest category of antidepressants, being the first kind to be developed, they are potent and closely linked to Dry Mouth . Perhaps luckily, they are less commonly prescribed for anxiety.

Benzodiazepines and antihistamines

These drugs have a relaxing effect and are prescribed for short-term treatment or longer-term management depending upon the circumstances, severity of symptoms or other medical conditions. Benzodiazepines include medications such as diazepam and alprazolam; antihistamines prescribed for anxiety include, but not limited to, hydroxyzine. They are all known to cause Dry Mouth.

Beta blockers

Typically prescribed for heart conditions, beta blockers help stop the body’s ‘fight or flight’ response. This is characterized by a rapid heartbeat, pounding chest and cold sweat and will be familiar to those who suffer from panic attacks. Beta blockers are sometimes prescribed for people prone to social anxiety or panic attacks, because they stop the physical symptoms. Unfortunately, beta blockers, such as propranolol, are also one of the groups of medications most closely linked to Dry Mouth.

If you think your antianxiety or any medication may be causing Dry Mouth symptoms, have a word with your doctor. You should also refrain from smoking or drinking alcohol, which can make Dry Mouth worse. Finally, find some relief from Dry Mouth symptoms with the Biotène Oral Rinse, Oralbalance Gel, and Moisturizing Spray products.

HOW TO REDUCE HYPOSAILIVATION

The unpleasant sensation of dry mouth is said to begin when there is a 45 percent or more decrease in normal saliva production. Also, a feeling of dry mouth is possible with a change in the normal composition of saliva. However, this condition is not always the main one because other symptoms found in this patient population are often perceived as more important.

Dry mouth can be manifested by dysphagia (impaired swallowing), oral discomfort, loss of taste and prolonged chewing of food, and can also have a significant negative impact on quality of life. Hyposalivation also causes difficulty speaking, and mouth discomfort may be exacerbated by denture wearers. Patients with dry mouth may develop lesions and cracks in the oral mucosa, and bad breath can be another unpleasant feature.

Xerostomia can lead to malnutrition and even reduced social interaction. Patients with dry mouth also have a higher risk of developing caries. Decreased saliva production predisposes patients to an overgrowth of Candida albicans, which causes oral thrush (candidiasis). In patients who have received radiation therapy to the head and neck, widespread caries is detected several weeks after treatment.

Approximately 90 percent of saliva is produced by the major salivary glands, the parotid, submandibular, and sublingual glands. The remaining 10 percent is secreted by hundreds of minor salivary glands under the oral mucosa. It is believed that in healthy people saliva is about one liter per day.

Causes of xerostomia
Quite often, drug treatment can be the main cause of dry mouth or a factor contributing to the development of xerostomia: reducing the secretion of saliva (hyposalivation) or changing the composition of saliva.

Over 500 drugs are believed to cause dry mouth, including cancer chemotherapy. The risk of xerostomia increases with the amount of medication taken by the patient.

Listed below are some of the more common medications that cause dry mouth. For example, opioids can cause dry mouth, as can tricyclic antidepressants, antihistamines, and diuretics. Drugs with antimuscarinic properties can significantly reduce saliva production. Nasal congestion and subsequent mouth breathing can lead to dryness of the mouth, lips, and throat.

Dry mouth preparations:

Drugs used to treat parkinson’s disease
Benzodiazepines
Bronchodilators (ipratropium bromide)
Serotonin reuptake inhibitor antidepressants (citalopram, fluoxetine, sertraline)
Tricyclic antidepressants (amitriptyline)
Atropine
Medicines for irritable bowel syndrome
Drugs for the treatment of frequent urination (oxybutynin, tolterodine, solifenacin)
Diuretics (furosemide, thiazide diuretics)
Antihypertensive drugs (captopril, enalapril, clonidine, lisinopril)
Anticonvulsants (carbamazepine)
Antihistamines

Fluid intake is important, as is the psychological state of the patient. Anxiety and chronic stress can be major contributors to dry mouth due to autonomic hyperactivity. Caffeine and nicotine intake can also contribute to dry mouth.

Xerostomia is common in cancer patients. Approximately 30 percent of cancer patients have problems with dry mouth, which worsens as the disease progresses. Radiation therapy to the mouth, head, or neck can cause severe xerostomia and hyposalivation. Salivary gland tissue is very sensitive to ionizing radiation and a dose > 30 Gy can irreversibly alter salivary secretion depending on the location of the salivary glands relative to the radiation therapy field.

Dry mouth can be caused by a variety of conditions and is not necessarily the result of an existing cancer or treatment regimen. There is an association of xerostomia with aging, with prevalence tending to increase with age, accounting for approximately 30 percent of the population over 65 years of age. Diabetes can cause dry mouth, as can other systemic conditions such as thyroid disease, rheumatoid arthritis, and Sjögren’s syndrome. Sarcoidosis and hemochromatosis are examples of rarer conditions that can lead to destruction of the salivary glands. It is also believed that the syndrome of transplant rejection (eg, kidney) contributes to the development of symptoms of dry mouth.

Therapy and symptomatic treatment xerostomia
First of all, the reversible causes of xerostomia should be targeted. Talk to your doctor about your medications to determine if you can stop taking them or reduce your dosage. Alternative drugs may have less antimuscarinic properties. Any associated infections such as candidiasis should be treated with antifungal tablets, suspensions or gels (miconazole).
Patients with mouth breathing may be given a short course of topical nasal decongestants (xylometazoline, oxymetazoline). As mentioned above, dry mouth can be caused by excessive anxiety and / or chronic stress, so this possible cause should also be eliminated if possible.

Practical symptomatic treatment options can help. Frequent water intake throughout the day may be sufficient for some patients. Holding ice cubes in your mouth to provide some moisture may also relieve symptoms. Other measures include sucking on pineapple slices, frequent sips of cold orange juice or semi-frozen fruit juice, or chewing sugar-free gum. Patients may find it helpful to use olive oil, and some products containing olive oil have been shown to be helpful in the symptomatic treatment of dry mouth.

Saliva substitutes are widely used for patients with xerostomia. Various formulations exist, including rinses, aerosols, chewing gums, and dentifrices, and they may also play a role in stimulating salivary gland secretion. It is possible to use saliva substitutes before meals. Also, preparations containing hyaluronic acid are used to moisturize the oral cavity – sometimes in combination with amino acids.

In particular, VITA-GIAL spray (sodium hyaluronate), can be used to periodically moisturize the oral cavity throughout the day. Hyaluronic acid not only moisturizes the oral cavity, but also restores the damaged mucosa, and also envelops it – preventing the penetration of bacteria through microcracks.

VITA-HYAL gel has a longer duration of action than an aerosol and is usually applied to the oral mucosa in the morning and before bedtime. Sometimes it is necessary to apply it additionally – after a meal.

Good oral hygiene is also essential. Some patients may be recommended treatment with pilocarpine, which stimulates the secretion of the salivary glands, but it has a lot of side effects.

You can buy “Vita-Gial” in our online store rivierabiotech.store

Second generation antidepressants for winter depression

Relevance

Seasonal affective disorder (winter depression) is a type of depression that appears in autumn and persists until spring. Its symptoms are similar to those of ordinary depression, except that patients suffering from such depression tend to experience extreme fatigue and increased appetite. The disorder is more common in countries with a lack of light hours during the winter season. One of the main treatments for all types of depression, including winter depression, are second-generation antidepressants (A-II), such as selective serotonin reuptake inhibitors (SSRIs) and selective serotonin and norepinephrine reuptake inhibitors (SSRIs). It is not known how well these medications work and how they compare to each other or to other treatments for winter depression, such as light therapy.

Results

We found three clinical trials with a total of 204 participants that tested A-II (fluoxetine) alone versus placebo (dummy) or light therapy. In one clinical trial (68 participants), fluoxetine was compared with placebo, although participants who received fluoxetine responded more frequently to treatment, there was not enough data to say with certainty that there was any difference from placebo. Approximately the same number of participants in both groups experienced side effects.

We found two clinical trials with a total of 136 participants comparing fluoxetine and light therapy. When we combined the results of these two trials, we found that both treatments were similar in their effects, with about 66 out of 100 people improving in both the fluoxetine and light therapy groups. The number of participants with side effects was also about the same in both the fluoxetine treatment group and the light therapy group.

We found five additional studies that provided safety data for A-II in the treatment of winter depression. They reported side effects A-II: bupropion, fluoxetine, escitalopram, duloxetine, nefazodone, and reboxetine. We were not able to directly compare these medications, but we can note that between 0% and 25% of people dropped out early due to side effects, and the most common side effects were nausea, diarrhea, sleep disturbances, decreased libido, dryness. in the mouth and anxiety. We were unable to compare the incidence of side effects in people taking A-II compared to placebo, which means our confidence in the side effect information is limited.

Dry mouth prozac: Dental note: Oral and dental effects of antidepressants

Meta-analysis: Risk of dry mouth with second generation antidepressants

Affiliations

Authors

Affiliations

Abstract

Similar articles

Cited by

Publication types

MeSH terms

Substances

Are Your Anxiety Medications Causing Dry Mouth?

Selective serotonin reuptake inhibitors (SSRIs)

Serotonin-norepinephrine reuptake inhibitors (SNRIs)

Tricyclic antidepressants (TCAs)

Benzodiazepines and antihistamines

Beta blockers

Related articles

HOW TO REDUCE HYPOSAILIVATION

Second generation antidepressants for winter depression

Leave a Reply Cancel reply