SSRI Side Effects and Long-Term Effects

Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed medications for moderate to severe depression. Many people who take SSRIs report unwanted side effects that include bruxism. In other words, you may find yourself grinding your teeth and clenching your jaw after taking this type of medication. A common question among those experiencing these symptoms is, does bruxism from SSRI go away? Understanding the timeline and treatment options can help you manage this challenging dental issue. This guide also covers other common SSRI side effects and what to know about long-term antidepressant use.
Bruxism, pronounced BRUK-siz-um, is a condition where you grind, gnash or clench your teeth.

Understanding Antidepressants and Their Impact

The term antidepressant is tossed around a lot in conversation, even in the mental health profession. But the truth is that antidepressants are a category of drugs that vary widely in what they do, what they help treat and their potential side effects. Zoloft (sertraline) and other antidepressants are used to treat depression, as the name suggests, but they can also be used in the treatment of various other conditions, including:

• Eating disorders
• Chronic fatigue syndrome
• Certain autoimmune disorders
• Anxiety disorders
• Nerve pain

How These Medications Work

Antidepressants is a broad term and can be broken down into more specific categories:

• Selective serotonin reuptake inhibitors (SSRIs)
• Serotonin and norepinephrine reuptake inhibitors (SNRIs)
• Tricyclic antidepressants (TCAs)
• Monoamine oxidase inhibitors (MAOIs)

Brain chemicals known as neurotransmitters act as messengers that send information between neurons (brain cells). The neurotransmitters most commonly linked to depression are dopamine, serotonin and norepinephrine. When these emotion-regulating neurotransmitters fail to carry messages properly or carry them inefficiently, it can result in depression.

Zoloft and other SSRIs increase serotonin levels in the brain by blocking the reuptake (reabsorption) of it into the neuron. This results in higher availability of serotonin, which improves the communication between neurons. Some common SSRIs include Zoloft, Lexapro and Prozac.

TCAs and MAOIs are some of the first antidepressants created and function similarly to the previously mentioned SSRIs. Although still in use, they’ve given way to SSRIs and SNRIs, which are more commonly prescribed today.

SSRIs and Bruxism (Teeth Grinding)

Symptoms Associated With Bruxism

Signs of SSRI-associated bruxism can include:

• Clenching or grinding teeth during the day or while sleeping
• Jaw pain and stiffness
• Headaches
• Damaged, loose, chipped or fractured teeth
• Dry mouth
• Tooth sensitivity or pain
• Exposed tooth areas with worn enamel
• Pain in the ear, face or neck

Bruxism is associated with sleep apnea, a condition in which breathing repeatedly pauses during sleep. It may also occur alongside other sleep disorders like insomnia. Many people don’t realize they have bruxism until complications develop, especially if the symptoms only occur during sleep. Others find out from their sleep partners because the grinding makes unwanted noise at night.

Why SSRIs Cause This Odd Side Effect

Bruxism associated with SSRI use may affect both children and adults prescribed these antidepressants. In a review of published case reports, venlafaxine (Effexor), sertraline (Zoloft) and fluoxetine (Prozac) were the drugs most commonly linked to this side effect.

SSRI-related bruxism is believed to arise from the drugs’ effects on dopamine levels in the brain. While SSRIs primarily work by increasing serotonin, they can also deplete dopamine, a brain chemical that impacts both mood regulation and motor function. This suppression of dopamine may trigger involuntary jaw-clenching behavior. Similar dopamine-related mechanisms are seen in movement disorders such as Parkinson’s disease, which is also associated with limited dopamine.

Treatment Options for Bruxism

Treatment can often alleviate the effects of bruxism, particularly if you experience dental complications. Your dentist can prescribe a mouth guard or splint to prevent the grinding and clenching motion. They fit over the teeth and may be worn during the day and at night. You may need fillings or crowns to repair damage if teeth become worn, cracked or broken.

Sometimes, the alignment of your teeth and jaw can lead to bruxism or worsen SSRI-related bruxism. In this case, your dentist can evaluate your bite to determine whether orthodontic treatment could resolve teeth grinding or related complications. People with missing teeth may find that getting implants or crowns addresses bruxism concerns.

Some people find that managing stress and anxiety reduces or resolves teeth grinding. You may want to try relaxation techniques such as yoga, meditation and talk therapy. You can also consider biofeedback, a type of physical therapy that helps you control the muscle activity involved in clenching and grinding your teeth. Doctors sometimes prescribe Botox injections or muscle relaxants to treat severe cases of bruxism. Facial massages can relieve the pain of tight muscles in the neck and jaw area.

Lifestyle changes can potentially reduce the impact of tooth grinding on your health. You can reduce dietary caffeine by limiting items like coffee, chocolate and soda. Alcohol can also contribute to excessive jaw clenching. Avoid chewing on non-food items, which can also make teeth grinding worse over time. Try keeping the tip of your tongue between your teeth to discourage the grinding motion.

Coping With Side Effects of SSRIs

Some side effects of SSRIs resolve after your body adjusts to the drug. In the case-report review discussed above, symptoms like dry mouth and grinding teeth began within a month after participants started taking the drug and resolved within a month after they stopped treatment.

When side effects persist, it’s important to balance the discomfort with the ability of the medication to control your depression symptoms. If you struggle with side effects, your healthcare provider may recommend a different antidepressant. Some people find that bruxism resolves if their doctor adds buspirone (an anxiety medication) to their treatment regimen. It’s important to keep an open line of communication with your doctor so you can find a solution for both your mental health concerns and SSRI side effects.

Although SSRIs work in similar ways, different drugs have different effects on the body. In addition to bruxism, side effects resulting from SSRI use may include appetite changes, dizziness, restlessness, difficulty sleeping, dry mouth, fatigue, headache and upset stomach. However, if you find that you can’t tolerate the side effects of one type of antidepressant, your healthcare provider can likely find a different drug that works better for you.

Even if you experience side effects, you shouldn’t stop taking your antidepressant without telling your doctor. Some of these drugs can cause withdrawal symptoms if you abruptly discontinue use. If you don’t gradually decrease the amount of the SSRI you take, you could experience fatigue, dizziness, nausea, nervousness and flu-like symptoms.

Is Dry Mouth Related to SSRI-Induced Bruxism?

Dry mouth is a separate but common side effect of SSRIs that can occur alongside bruxism. Both conditions may be present simultaneously, and dry mouth can actually worsen the dental complications associated with teeth grinding. Reduced saliva flow increases the risk of tooth decay and gum disease, which can compound the damage from bruxism.

What Are Some Long-Term Side Effects of Zoloft and Other Antidepressants?

Every medication has side effects, and antidepressants are no different. However, it’s important to understand that the side effects often reported for antidepressants are for the class as a whole. To know what to watch out for, ask your doctor for a list of the possible side effects specific to your medication. Here are a few of the common long-term side effects of antidepressants.

Weight Gain

Weight gain can be brought on by antidepressants altering serotonin receptors. This is especially true for women.

Traditionally, antidepressants have been known to cause weight gain when taken over time. How much weight you put on depends on the medication you’re prescribed, how long you take it and your body’s unique chemistry. Some people may find they don’t gain weight at all while on an antidepressant. In some cases, it may not be a side effect of the drug but instead related to a lifestyle change.

For example, someone with anxiety or depression might struggle to cook for themselves or eat nutritious meals. When the antidepressant starts to control these symptoms, the person may want to eat more and may have more energy and desire to cook. The subsequent weight gain this person might experience, therefore, isn’t caused by the medication itself.

However, some antidepressants can cause weight gain, and it’s something to be aware of. This is because being overweight can increase your risk of other health concerns, such as high blood pressure. If you’re concerned about gaining weight while on an antidepressant, weigh yourself regularly and ask your doctor about strategies to control your weight in a healthy way.

Blood Sugar and Diabetes Risk

Type 2 diabetes and irregular blood sugar regulation can result from long-term antidepressant use. One reason for this is the potential for weight gain. SSRIs can also have a negative impact on blood sugar for those with preexisting diabetes. Additionally, tricyclic antidepressants are known to cause hyperglycemia.

In general, being overweight can mean your blood sugar levels aren’t as controlled as they should be, and this can lead to Type 2 diabetes. Those who are dealing with depression may also be more prone to eating processed convenience foods that are easier to prepare and may not be getting enough daily exercise. These factors can also increase the likelihood of blood sugar control issues and Type 2 diabetes.

Some studies have linked SSRIs and tricyclic antidepressants to higher blood sugar levels. If you have a family history of diabetes or other risk factors, it’s a good idea to talk to your doctor about whether a different type of antidepressant might be more suitable for you. Your doctor can also give you some tips on managing your blood sugar level through diet and lifestyle changes to help mitigate the possible effects of the medication.

Decreased Antidepressant Effect

Perhaps one of the most important long-term antidepressant effects is that they can become less effective over time. This means the dose used at the beginning of your treatment that worked well to control your symptoms may become less effective than it was originally. While it’s sometimes possible to just increase the dosage, this isn’t an option in every case or with every medication.

In some situations, you may have to start over to find a new antidepressant that works to control your symptoms. This can often bring with it an uncomfortable adjustment phase and some uncertainty as you balance controlling your symptoms with watching for side effects or other issues with the new medication.

Decreased efficacy can also be a problem if you don’t recognize that it’s happening. Your symptoms could start to come back slowly, meaning you don’t immediately recognize that it’s a medication issue before things get too severe.

It’s possible to develop a tolerance to antidepressants over time. The scientific term for this is tachyphylaxis. There’s no final consensus as to why this happens to varying degrees between people, but factors can include age, stress levels, drug interactions and other preexisting mental health conditions.

Medical professionals may mitigate the developed tolerance by altering doses, switching medications or suggesting lifestyle changes.

Suicidal Ideation

Another possible side effect of using antidepressants is suicidal thoughts and feelings. Young adults under the age of 25 are particularly vulnerable to this, especially within the first weeks of taking the medication.

If you or someone you know is in crisis, call or text 988 to reach the 988 Suicide & Crisis Lifeline, or call 911 in an emergency.

Treatment-Resistant Depression

There are also cases in which patients don’t respond to antidepressants at all. This condition is known as treatment-resistant depression (TRD) and is corrected in much the same way as when long-term tolerance develops.

For those experiencing TRD, several treatment options exist:

• Trying different medications or combinations
• Adding psychotherapy or counseling
• Exploring alternative treatment methods
• Considering newer therapeutic approaches

The Bottom Line

If the list above sounds a little scary to you, that’s normal. Although it’s wise to be aware of potential side effects, it’s important to take a step back and look at the bigger picture. Most antidepressants are considered very safe, even for long-term use, and the larger concern for most people is finding an antidepressant that regulates their symptoms well over time. If you’re concerned about sertraline side effects long-term, talk with your health care team to determine what your risk factors are and what medications or alternative therapies may be available. This can help ensure your symptoms are under control and your risk of long-term side effects is as low as possible.

The Benefits of Residential Mental Health Treatment

It can be difficult to determine whether a particular SSRI makes sense for your mental health treatment, especially when a drug comes with unwanted side effects that disrupt your life and health. You need to consider a range of factors that include your personal physical and mental health history, family history, lifestyle, behavior, symptoms you experience, possible interactions with other medications you take, other health conditions you have and whether you’re pregnant, breastfeeding or trying to conceive. Spending time in a residential mental health care program can help you land on the right management plan for your diagnosis, whether or not that includes medication.

At Restore Mental Health in Deerfield Beach, we provide comprehensive care that addresses both your mental health needs and the challenges of managing medication side effects. Our experienced team works with you to find the right treatment approach, including medication management and therapeutic interventions. Call (877) 810-2074 or reach out to Restore today to learn more about your options for a healthier life.