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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by francineus on August 24, 2008, at 18:20:26
I'm taking Imipramine, and lithium and klonopin prn for treatment resistant depression. The pdoc added
ritalin (concerta) since lithium was makine me exhausted. I found that the ritalin helped tremendously with the depression but has now (after
months of use) caused me to have these weird mouth
tics, like grinding my jaw. It's embarrassing yet I dread the idea of going off of ritalin as it has been so helpful. Any ideas. I've taken low doses of klonopin to see if that helps but it doesn't.
Posted by med_empowered on August 24, 2008, at 19:20:44
In reply to HELP! TRD...Ritalin and Involuntary mouth tics?, posted by francineus on August 24, 2008, at 18:20:26
I dunno man..the stimulants sometimes cause weird tics b/c of their effects on the dopamine system (same reason antipsychotics can wreak havoc on your bodily movements).
Personally, I had tics on Ritalin, but I didn't get them on Adderall. Could you doc switch you to an amphetamine and see if that helps? The only other thing I can thing of would something to suppress the tics, like a low-dose antipsychotic or maybe Tenex or clonidine (I'm not a doc, obviously--I'm just throwing stuff out there for you).
But seriously: If I were you, I'd ask about an amphetamine....they're more potent than Ritalin and most people find them "smoother."
Posted by Nadezda on August 26, 2008, at 12:04:15
In reply to HELP! TRD...Ritalin and Involuntary mouth tics?, posted by francineus on August 24, 2008, at 18:20:26
Hi, Francineus. Sorry about the mouth tics. I got something rather like that on cylert. My pdoc said, correctly, that it would resolve after I got off the cylert-- but it was important to get off. It can take less or more time to resolve, too. So you really need to talk to your pdoc ; if it's caused by the ritalin, probably it's wise to get off it.
But as med_empowered said, there's a good chance you can use an amphetamine like adderall. I haven't had any problems on ritalin or adderall, despite having them on cylert. So the reaction doesn't necessarily apply to all stims.
Good luck. Hope your jaw grinding subsides.
Nadezda
Posted by yxibow on September 2, 2008, at 2:31:04
In reply to HELP! TRD...Ritalin and Involuntary mouth tics?, posted by francineus on August 24, 2008, at 18:20:26
> I'm taking Imipramine, and lithium and klonopin prn for treatment resistant depression. The pdoc added
> ritalin (concerta) since lithium was makine me exhausted. I found that the ritalin helped tremendously with the depression but has now (after
> months of use) caused me to have these weird mouth
> tics, like grinding my jaw. It's embarrassing yet I dread the idea of going off of ritalin as it has been so helpful. Any ideas. I've taken low doses of klonopin to see if that helps but it doesn't.
>
I would certainly mention the jaw grinding to your doctor when you next see him. Bruxism is a common anxiety condition, but it also is a side effect of medications, not just dopamine but others. One has to weigh the benefits and risks of this situation.If you have dental insurance and it covers it or other insurance will conver it, I would definitely suggest getting a "night guard" that is professionally made (they take a mold of your mouth and produce a small plastic thing that is like a retainer but a bit hard to talk with). There are store kits but they aren't as reliable.
I have a night guard which I used to also wear as a day guard because I have a medicine induced oral-buccal tic.
I haven't in a while though I should, but I have memory issues now and I can forget possessions -- side tangent, not part of this discussion.But it does make a difference in how you feel the day after or even if you have to wear it during the day. They last several years at least, if not more, depending how you use it.
Botox is a treatment for severe bruxism, but botox always comes with risks and has to be repeated -- this is something for an oral surgeon I would think and is a more drastic palleative
-- best wishes
Jay
This is the end of the thread.
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