#119 Fact Checking TMD/TMJ (Part 4) Neuroleptic Drugs
According to the dictionary, a neuroleptic drug is any drug that tends to reduce nervous tension by depressing nerve functions. There are several categories of neuroleptic drugs. These include Benzodiazepines, (Xanax, Librium, Valium, Klonopin, Serax), and SSRI’s, (Celexa, Lexapro, Prozac, Luvox, Paxil, Zoloft). Benzodiazepines and SSRI’s are the two most commonly prescribed categories of neuroleptic drugs in the U.S. Other categories include drugs used as mood stabilizers, antipsychotics, and antidepressants. The purpose of this article is not to point out the generic and trade names for these numerous drugs but to discuss whether any of them are suitable to be used for the treatment of TMD/TMJ.
The use of neuroleptic drugs for the treatment of TMD/TMJ is relatively common in both private practice and teaching programs. I am aware of several well thought of university programs that promote the use of neuroleptic drugs for the treatment of TMD/TMJ. Their use is rationalized as follows:
- Bruxism, or clenching and grinding the teeth, is one of the three primary causes of TMD/TMJ. Acute trauma and functional malocclusion are the other two.
- There is a poorly defined relationship between fear, anxiety, stress and bruxism. This fact is intuitive and generally agreed upon. People who are anxious frequently clench and grind their teeth. It is even mentioned in several bible verses. Matthew 13:42: “and will throw them into the furnace of fire; in that place there will be weeping and gnashing of the teeth”
- If you can decrease fear, anxiety, and stress it will decrease Bruxism.
- Prescribing drugs that decrease fear, anxiety, and stress will decrease bruxism and therefore decrease the symptoms of TMD/TMJ.
- Therefore, prescribing neuroleptic drugs is an appropriate method to treat TMD/TMJ.
I am aware that one of the most renowned teaching programs in the country that uniformly prescribes Amitriptyline, (Elevil, Laroxyl), for everyone who presents with symptoms of TMD/TMJ. No other treatment options are offered.
The side effects of neuroleptic drugs include, drowsiness, blurred vision, changes in sex drive, weight gain, dry mouth, constipation, vomiting, low blood pressure, restlessness, mental fog, loss of motivation, social withdrawal, tardive dyskinesia, (involuntary motions of the mouth), tics, tremors, Type 2 Diabetes, and substantial withdrawal symptoms once discontinued.
The facts associated with using neuroleptic drugs for treating TMD/TMJ are as follows:
- There are no scientific articles which show that prescribing neuroleptic drugs decrease the symptoms of TMD/TMJ.
- The doctors and university programs that prescribe neuroleptic drugs for the treatment of TMD/TMJ do so without any scientific support and validation.
- The doctors and university programs that prescribe neuroleptic drugs for the treatment of TMD/TMJ do so “Off Label”, which means they are using these drugs for a purpose that has not been reviewed by nor approved by the FDA.
- Patients who use neuroleptic drugs for the treatment of TMD/TMJ need to be made aware of the multitude of serious side effects associated with their use.
- Patients have the ultimate authority as to whether to accept or reject the use of neuroleptic drugs for the treatment of TMD/TMJ.
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