Selective serotonin reuptake inhibitors (SSRIs) are effective in the treatment of depression. Adverse effects are generally mild and transient, resulting in high patient tolerability. The occurrence of a rare adverse effect, bruxism, shortly after sertraline was initiated in a patient is described.
A 65-year-old man presented to the Family Medicine Clinic at the Toronto Hospital, Toronto, Ontario in early November 1994 with a two-year history of severe depression. Symptoms included decreased concentration, decreased short term memory, tearfulness and loneliness. The patient had recently finalized a difficult divorce. He had previously refused any medical treatment for depression. However, anticipating an upcoming lonely holiday, the patient suffered worsening depression and he consented to therapy.
Medical problems included noninsulin dependent diabetes mellitus, coronary artery disease, hypertension, hyperlipidemia, peripheral vascular disease, atrial flutter and impotence. Medications included glyburide 5 mg orally bid, enalapril 5 mg bid, digoxin 0.25 mg/day, propafenone 150 mg tid, enteric-coated acetyl-salicylic acid 325 mg/day and lovastatin 20 mg at bedtime. He denied alcohol use and had quit cigarette smoking two years previously. Past surgical history included two femoral bypass surgeries in 1977 and 1987, a pacemaker insertion in 1992 and a penile prosthesis.