Consecutive Controlled Case Series on Effectiveness of Opipramol in Severe Sleep Bruxism Management—Preliminary Study on New Therapeutic Path

Abstract

Background: Sleep bruxism (SB) management aims to reduce the number and magnitude of bruxism episodes per hour of a patient’s sleep and, therefore, reduce the potentially negative clinical consequences. Opipramol belongs to the group of tricyclic antidepressants (TCAs) and is considered as an atypical TCA, as it acts primarily as a sigma receptor agonist. This study aimed to preliminarily determine the effectiveness of opipramol in the management of severe SB. Methods: A total of 19 otherwise healthy participants with severe SB diagnosed during stage I video polysomnography (vPSG) were subjected to an 8-week pharmacotherapy trial with a 100 mg bedtime daily dose of opipramol and were then analyzed by control stage II vPSG. Results: The participants included 14 females and 5 males, aged 20–47 years (mean ± standard deviation: 32.32 ± 8.12). A comparison of stage I and II vPSG recordings showed a decrease in all the studied SB parameters in 78.85% of participants. Only in a small group of participants (15.53%) was a non-significant increase of SB parameters observed. Conclusions: A single 100 mg dose of opipramol at bedtime seems to positively affect the reduction of SB in otherwise healthy individuals diagnosed with severe SB. However, the subject requires further research on a larger population including a control group.

Managements of sleep bruxism in adult: A systematic review

“…Symptomatological hypotension (n = 3/16), reduction of systolic blood pressure, and thirst in clonidine [23] , nausea (n = 3/13), drowsiness (n = 3/13), poor sleep (n = 1/13), and blurred vision (n = 1/13) were reported with pramipexole [79] . An increase of Apnea-Hypopnea Index and Oxygen Desaturation Index in male participants was reported with opipramol administration and facial changes due to masseter intramuscular injection were reported in BTX-A [68] , [74] .…”

“…The effect of bromocriptine (7.5 mg/night) application was assessed by three clinical trials, and they showed similar results, such as a significant reduction in the root mean square of masseter EMG during SB; however, there was no tendency to reduce the number of episodes per hour, the number of bursts per episodes, number of bursts per hour, and number of episodes with noise [66] , [67] . The effect of opipramol (100 mg/night) administration was evaluated in one clinical trial, which showed a significant reduction in the number of episodes per hour, but not in the number of bursts per hour [68] . The effect of clonazepam (1 mg/night) application was assessed in three clinical trials with four parameters.…”

Cardiovascular Implications of Sleep Bruxism—A Systematic Review with Narrative Summary and Future Perspectives

“…Nonetheless, small sample size and morning symptomatic hypotension were apparent and serious study limitations. A recent study by Wieckiewicz et al [ 56 ] concluded that opipramol, an atypical tricyclic antidepressant, reduced the amount of SB events (decreased BEI) in 78.95% of severe bruxers. Although the results appear promising, they suffer from study limitations, e.g., lack of control group, small study sample and lack of longitudinal observation to estimate the side-effects of the applied pharmacotherapy.…”

Therapies for sleep bruxism in dentistry: A critical evaluation of systematic reviews

“…This information could be useful for researchers who delve into this topic of great interest, taking into consideration a larger population with a control group and long-term follow-up periods. 32 It has also been suggested that bruxism is a risk factor for developing TMDs, since an increase in the activity of the masticatory muscles could cause joint overload and myofascial pain. However, almost all studies that point to such an association used non-validated methods to diagnose bruxism, which indicates a possible diagnostic bias that could have increased the level of significance of the discussed association.…”