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Dr. Bob is Robert Hsiung, MD,
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Posted by agencypanic on December 10, 2002, at 19:47:41
Sorry if this has been asked/answered in other posts.
I saw some other messages about jaw clenching but not together with
Zoloft.
Recently I began taking Z again for depression (I haven't taken it for about 4 years). I began at 50mg for two weeks, then
increased to 75mg for about a week and am now at 100 mg (this has been for about a week). I've noticed that I have
been clenching my jaw and perhaps my bearing in general is tense and I am
wondering if others have experienced anything similar or heard of this?
My pcp is pretty much letting me find the correct dosage since I've taken it before. I'm wondering if this tension is
dosage related, or just generally zoloft related, or neither.
Thanks for your help.
Posted by Sienna on December 10, 2002, at 21:44:24
In reply to Zoloft and jaw clenching, posted by agencypanic on December 10, 2002, at 19:47:41
How weird. I came here to post pretty much the same thing. Im having trouble with this too at 100 mgs and had gone up to 150 mgs but had to come back down because of a couple different side effects. but my jaw is definitely clenched and i dont know if this will go away with time or not.
Anybuddy know?
Sienna
Posted by bookgurl99 on December 11, 2002, at 0:05:48
In reply to Zoloft and jaw clenching, posted by agencypanic on December 10, 2002, at 19:47:41
I don't have jaw clenching, but I am on a low dose of zoloft -- 50 mgs -- and notice an overall increased feeling of tension. I thought it was just that I don't like my job and sit in a dark cubicle all day (drinking coffee) though. :D
Posted by medlib on December 11, 2002, at 11:17:33
In reply to Zoloft and jaw clenching, posted by agencypanic on December 10, 2002, at 19:47:41
Hi agencypanic--
It's a fairly good bet that the jaw tension/clenching you describe is EPS (extrapyramidal symptoms), a mixed bag of movement disorders thought to be caused by dopamine (DA) depletion in the substantia nigra portion of the brain. Some serotonin neurons 5HT2 type) synapse on DA neurons and inhibit their synthesis of DA. SSRIs such as Zoloft, which increase the availability of serotonin, can decrease the production of dopamine in a dose-dependent manner. This effect may also account for the emotional blunting some SSRI users experience.
Some SSRIs may be more likely to cause EPS than other antidepressants. It's been mentioned in connection with Zoloft, Prozac and Paxil (that I know of). Your pdoc should be notified.
Hope this helps a bit---medlib
Posted by Dinah on December 11, 2002, at 12:03:51
In reply to Re: Zoloft and jaw clenching » agencypanic, posted by medlib on December 11, 2002, at 11:17:33
If a lack of dopamine causes emotional blunting, why does the excess dopamine in schizophrenia also cause the negative symptoms of schizophrenia?
Posted by Kari on December 11, 2002, at 12:54:55
In reply to Re: Ok, now I'm (still) confused » medlib, posted by Dinah on December 11, 2002, at 12:03:51
Posted by IsoM on December 11, 2002, at 14:53:09
In reply to Re: Ok, now I'm (still) confused » medlib, posted by Dinah on December 11, 2002, at 12:03:51
Dinah, most EPS are seem with any medication that depletes or lowers dopamine levels. Anti-psychotics are notorious for causing these problems. Parkinson's symptoms are similar to EPS because of the way the disease affects dopamine levels. Dopamine is also involved with pleasure, contentment, & a general overall good alert feeling. Stimulants increase dopamine levels. It is very complicated the way neurotransmitters interact (as you already know).
So medlib was saying that many SSRIs seem to lower dopamine levels over time. Lower dopamine levels lead to blunting of emotions like motivation & enthusiasm & can also lead to some EPS problems such as rigidity (like jaw clenching).
This site gives you an idea of what some EP symptoms are:
http://www.hubin.org/publicfamilyinfo/treatment/side_effects/side_effects_6_en.html
Posted by Dinah on December 11, 2002, at 15:48:29
In reply to Extrapyramidal symptoms and dopamine » Dinah, posted by IsoM on December 11, 2002, at 14:53:09
I did understand that part, but what I don't understand is that the negative symptoms of schizophrenia also involve emotional blunting, and schizophrenia is related to an excess of dopamine (if I remember correctly). So both an excess and a depletion of dopamine cause emotional blunting?
Or am I completely confused.
Posted by Ritch on December 12, 2002, at 0:16:12
In reply to Re: Extrapyramidal symptoms and dopamine » IsoM, posted by Dinah on December 11, 2002, at 15:48:29
> I did understand that part, but what I don't understand is that the negative symptoms of schizophrenia also involve emotional blunting, and schizophrenia is related to an excess of dopamine (if I remember correctly). So both an excess and a depletion of dopamine cause emotional blunting?
>
> Or am I completely confused.Dinah, you have a great question. Does excess dopamine result in excessive FEAR that *stifles* AFFECT (due to neurotic hypervigilance OR paranoia)? If you have the *opposite* of FEAR (apathy??), does this also create a lack of affect? Perhaps "normal affect" is somewhere between those two poles? I remember a visit with a neurologist and his technician and being told something like "you have warm affect, that is good". So does this "warm affect" fall in the middle of A CONTINUUM between APATHY and FEAR? IOW, too much dopamine makes you too fearful, so all you can do is be hypervigilant, and too little makes you apathetic and unreactive and unconcerned with the world around you?
Posted by bluedog on December 12, 2002, at 1:08:44
In reply to Re: Extrapyramidal symptoms and dopamine » Dinah, posted by Ritch on December 12, 2002, at 0:16:12
I remember a visit with a neurologist and his technician and being told something like "you have warm affect, that is good". So does this "warm affect" fall in the middle of A CONTINUUM between APATHY and FEAR? IOW, too much dopamine makes you too fearful, so all you can do is be hypervigilant, and too little makes you apathetic and unreactive and unconcerned with the world around you?
Ritch
My personal opinion is that you are in fact correct when you speak of this CONTINUUM between apathy and fear.
Dr Paul Cheney who is a Chronic Fatigue Syndrome(CFS) specialist refers to this continuum as a line between COMA and SEIZURE. He explains this view in the following article on Klonopin which I have linked to previously. It is a matter of getting the BALANCE between APATHY/FEAR or COMA/SEIZURE just right. Of course the complexities in our brains makes it difficult to achieve this correct balance!!!!
Anyway here is the link I was referring to. see http://www.immunesupport.com/library/showarticle.cfm/id/3154/searchtext/klonopin/
My views could be completely wrong as it merely represents my personal opinion but I was able to draw an analogy between your post and the information presented in the article that I linked to.
regards
bluedog
Posted by Ritch on December 12, 2002, at 9:46:32
In reply to Re: Apathy/Fear continuum!!! » Ritch, posted by bluedog on December 12, 2002, at 1:08:44
> I remember a visit with a neurologist and his technician and being told something like "you have warm affect, that is good". So does this "warm affect" fall in the middle of A CONTINUUM between APATHY and FEAR? IOW, too much dopamine makes you too fearful, so all you can do is be hypervigilant, and too little makes you apathetic and unreactive and unconcerned with the world around you?
>
> Ritch
>
> My personal opinion is that you are in fact correct when you speak of this CONTINUUM between apathy and fear.
>
> Dr Paul Cheney who is a Chronic Fatigue Syndrome(CFS) specialist refers to this continuum as a line between COMA and SEIZURE. He explains this view in the following article on Klonopin which I have linked to previously. It is a matter of getting the BALANCE between APATHY/FEAR or COMA/SEIZURE just right. Of course the complexities in our brains makes it difficult to achieve this correct balance!!!!
>
> Anyway here is the link I was referring to. see http://www.immunesupport.com/library/showarticle.cfm/id/3154/searchtext/klonopin/
>
> My views could be completely wrong as it merely represents my personal opinion but I was able to draw an analogy between your post and the information presented in the article that I linked to.
>
> regards
> bluedog
>
>Hey that's cool. I like analogies. Read the article. I found it interesting about how nerve cells get "killed" that don't stop firing. It is almost like they are like fuses for electric current with *fusible links*. I also like his concept of "Neuroprotection via threshold potentials". Now I wonder about the "shape" of the normal/waking/functional/nontoxic region of that continuum and how that might vary from individual to individual. I suppose it could be possible that a constrained "envelope of normalcy" could be as much a problem as an unstable threshold that varies excessively in absolute terms. I like his concept about taking a very tiny dose (of an anticonvulsant-clonazepam here) should result in improved *clarity* without dulling. I have noticed that if I get too *zingy*, that a 1/4 of a .5mg tab of Klonopin in the daytime has helped me focus when I am under a lot of job stress. Thanks for that link! Food for thought.
Posted by Denise528 on December 12, 2002, at 9:47:44
In reply to Extrapyramidal symptoms and dopamine » Dinah, posted by IsoM on December 11, 2002, at 14:53:09
Hi IsoM,
Just wondering, if dopamine depletion causes with Parkinson's Disease and if lowering dopamine levels also blunts emotion, effects motivation etc then why is it that people with Parkinsons Disease don't necessarily suffer from depression or apathy.
I was reading a book by Michael J Fox and he seems a motivated, positive kind of person.
Also, why is it that when I take an antipsychotic like Zyprexa, which supposedly lowers dopamine levels, do I feel more motivated and alive? Could it be that when I initially take it it increases my dopamine levels in some way?
I know that nothing really is as simple as the above but I was wondering if you had any ideas on this?Denise
Posted by fluffy on December 12, 2002, at 13:01:53
In reply to Re: Extrapyramidal symptoms and dopamine » Dinah, posted by Ritch on December 12, 2002, at 0:16:12
This topic caught my eye because I was wondering why my jaw has been clenched for the past week or so. I have noticed it before, but I just started Tegretol 100mg for the treatment of bipolar II. I have been feeling OK, but lately, my jaw has started to ache because of the constant clenching. (esp. in the mornings after a full night of it).
I'm feeling like I'm on the verge of something, either a depressed or hypomanic jag...I've noticed that my jaw will do this right before a jag. Weird. Maybe I should tell my pdoc when I see him this monday.
Posted by chad_3 on December 12, 2002, at 13:12:13
In reply to Zoloft and jaw clenching, posted by agencypanic on December 10, 2002, at 19:47:41
Hi Agencypanic -
I will add (will be awhile) stuff on this to my website. Zoloft does not cause jaw clenching - at least this would be extremely rare - unless you have another problem going on.
Have you ever taken an antipsychotic (zyprexa, risperidone (risperdal), haldol ... etc) - or reglan?
Those drugs cause tardive movement disorders. They may exist at "subclinical levels" so the slightest drug change "brings out" the abnornmal movements. This sucks - because it means you may have medication intolerances which limit your treatment and thus your mental health.
Don't expect a Dr. to admit any mistake - or another psychiatrist to even admit a previous Dr's mistake.
I have been through a year of learning that coverup is routine - and a lawyer is required if you have an antipsychotic induced movement disorder.
Perhaps you have no history of antipsychotic use - but most stories I hear like yours there is past use - in any case if so you might talk (for free) to a lawyer specializing in such issues.
you can write me if you want as I have a story here of my own with movement disorders caused by a/p's.
chad
http://www.socialfear.com/
> Sorry if this has been asked/answered in other posts.
> I saw some other messages about jaw clenching but not together with
> Zoloft.
> Recently I began taking Z again for depression (I haven't taken it for about 4 years). I began at 50mg for two weeks, then
> increased to 75mg for about a week and am now at 100 mg (this has been for about a week). I've noticed that I have
> been clenching my jaw and perhaps my bearing in general is tense and I am
> wondering if others have experienced anything similar or heard of this?
> My pcp is pretty much letting me find the correct dosage since I've taken it before. I'm wondering if this tension is
> dosage related, or just generally zoloft related, or neither.
> Thanks for your help.
Posted by agencypanic on December 12, 2002, at 13:26:37
In reply to Jaw clenching - please read, posted by chad_3 on December 12, 2002, at 13:12:13
> Hi Agencypanic -
>> Have you ever taken an antipsychotic (zyprexa, risperidone (risperdal), haldol ... etc) - or reglan?
>5 years ago or more I took haldol for a short time-- ativan as well. I'm currently taking .25-.5 mg of ativan at bedtime.
Posted by vagen on December 12, 2002, at 14:19:09
In reply to Zoloft and jaw clenching, posted by agencypanic on December 10, 2002, at 19:47:41
I am a clencher. It's from stress.
I even have to sleep with a nightguard.If your jaw is popping and cracking when you eat and stuff, or yawn really hard and it pops like your joints do....try seeing a dentist.
Just a thought.
Posted by Kari on December 12, 2002, at 14:51:57
In reply to Re: To isoM, posted by Denise528 on December 12, 2002, at 9:47:44
I was wondering the same thing , after having a similar experience with APs. Could it be that excessive dopamine activity also causes an increase in levels of endorphins? Without meds I am constantly feeling "drugged", totally "out of it" and unable to have normal emotional reactions. This may be a blessing at times but it is simply abnormal.
Posted by Ritch on December 13, 2002, at 0:02:50
In reply to Re: Extrapyramidal symptoms and dopamine, posted by fluffy on December 12, 2002, at 13:01:53
> This topic caught my eye because I was wondering why my jaw has been clenched for the past week or so. I have noticed it before, but I just started Tegretol 100mg for the treatment of bipolar II. I have been feeling OK, but lately, my jaw has started to ache because of the constant clenching. (esp. in the mornings after a full night of it).
> I'm feeling like I'm on the verge of something, either a depressed or hypomanic jag...I've noticed that my jaw will do this right before a jag. Weird. Maybe I should tell my pdoc when I see him this monday.
I also experienced some jaw clenching (and tongue biting) with stimulants (Ritalin and Adderall) which tend to increase dopamine. When I experienced EPS symptoms in the past (due to antipsychotic use of Stelazine and Haldol) that were treated in the ER or at a physician's office with either Benadryl or diazepam injections, "jaw clenching" was not among any of my symptoms. The primary symptom with Stelazine was "torticollis" (a one-sided neck-muscle dystonia), and with Haldol was a lower back muscle dystonia (I couldn't stand up straight). So, I am not entirely sure that "jaw-clench" or "bruxism" (grinding of teeth) is an element of "EPS".
Posted by LyndaK on December 13, 2002, at 1:34:33
In reply to Re: Extrapyramidal symptoms and dopamine » fluffy, posted by Ritch on December 13, 2002, at 0:02:50
I didn't respond when I first saw this thread, but now I feel compelled.
Zoloft used to be my "drug of choice" before switching to the one I'm on now. One thing that I noticed about Zoloft is that it raised my muscle tone a bit in general. If I laughed at a joke and slapped the top of my leg I'd elicit a full blown knee-jerk response! Having brisk deep-tendon reflexes was definitely not my norm. -- but that's how I was on Zoloft. Jaw clenching was another thing that came to my attention while on Zoloft, but, I now know that I had a malocclusion that was causing TMJ problems. Was I clenching my jaw before Zoloft? Maybe. But it came to my attention while on Zoloft because I think my increased muscle tension in general was making that particular symptom much worse and much more noticable. I do not think it was EPS. I don't think it was anything dangerous. I think it was just another annoying side-effect.
Posted by chad_3 on December 13, 2002, at 2:20:03
In reply to Re: Jaw clenching - please read, posted by agencypanic on December 12, 2002, at 13:26:37
Hi Agencypanic -
If the jaw clenching is "involuntary" when your jaw would otherwise relaxed, that is a dystonic reaction - and is NOT tension / anxiety related jaw clenching which is under control of voluntary muscle control.
You took Haldol in past - I saw another poster also taking Haldol. These are the implicating drugs - and your Dr. screwed up and hid it from you if he knew of any abnormal movements.
You can still sue because you never knew - that is if you have a problem and you find out. A free consult with lawyer will help.
Also - in the meantime - between onset of movement disorder (Haldol or other antipsychotic) - and the present - any use of ANY antipsychotic or some other drugs like benzodizepines (Ativan) can MASK the problem. Ie; if you have been on a benzo or tranquiler of some sort for all this time that can "mask" the problem - a common way that Dr's hide their **** up's. (mess ups).
These are major issues and very common. If you look at Pubmed you will see so many articles on Reglan induced Tarvide movement disorders - and most all abstracts are blacked out.
Info is hard to find. Psychiatrists and neurologists are in the know and it remains a mostly silent problem - lawyers - specialists - also know about this stuff and are really the only way to correct psychiatric negligence.
Next site must be on this issue because I know it's common - it's known large % of neuro consults are drug induced movements - and most probably not handled in a way where lawsuit is possible without attorney ... unfortunately ...
a scam IMO but life isn't perfect ... they screw you and your choice to take it or not.Later,
Chad
http://www.socialfear.com/> > Hi Agencypanic -
> >
>
> > Have you ever taken an antipsychotic (zyprexa, risperidone (risperdal), haldol ... etc) - or reglan?
> >
>
> 5 years ago or more I took haldol for a short time-- ativan as well. I'm currently taking .25-.5 mg of ativan at bedtime.
Posted by IsoM on December 13, 2002, at 2:24:43
In reply to Re: To isoM, posted by Kari on December 12, 2002, at 14:51:57
I've been working more lately & the winter doldrums are in full swing for me - feeling quite tired physically & mentally. I'll get back to you both later & will post as a new thread.
Posted by Kari on December 13, 2002, at 15:08:08
In reply to for Denise and Kari, posted by IsoM on December 13, 2002, at 2:24:43
Hi IsoM,
Thanks for your response.
Take your time and get plenty of rest- don't overwork yourself.
Take care,
Kari.
Posted by cybercafe on December 13, 2002, at 17:44:25
In reply to Re: Zoloft and jaw clenching-or TMJ?, posted by vagen on December 12, 2002, at 14:19:09
> I am a clencher. It's from stress.
> I even have to sleep with a nightguard.
>
> If your jaw is popping and cracking when you eat and stuff, or yawn really hard and it pops like your joints do....try seeing a dentist.
>
> Just a thought.does TMJ treatment really work? i am considering seeing a dentist but i fear many appointments, high costs and little improvement
p.s. - my TMJ is from sports and genetics not meds (didn't want to scare anyone)
Posted by vagen on December 14, 2002, at 4:36:37
In reply to Re: Zoloft and jaw clenching-or TMJ?, posted by cybercafe on December 13, 2002, at 17:44:25
I finally got around to having this treated in Sept. I am not sure of the cost, (have good insurance) but it works like a charm. The stress was allievated from the jaw, neck and back and it ok to kiss now!
I know stress goes along with our interesting condition. I never really considered that it would be a SE from anything.
I fractured my jaw when I was younger......
Posted by bookgurl99 on December 14, 2002, at 8:46:19
In reply to Re: Zoloft and jaw clenching-or TMJ?cybercafe, posted by vagen on December 14, 2002, at 4:36:37
Vagen,
How was this treated? I've had pretty bad, increasingly worse TMJ for a few years. (Jaw clicks every time I chew, and has even locked up, rarely.)
bookgurl99
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