Shawky E. Mohamed

The purpose of this study was to evaluate the effect of a tricyclic antidepressant (amitriptyline) on nocturnal masseteric activity and duration of sleep in bruxists. Using a randomized, double blind, crossover design, ten females (mean age 39 yrs, +/- sd seven yrs) received active (amitriptyline 25 mg/night) and inactive (placebo 25 mg/night) medication, over a period of four weeks each. A portable EMG integrator recorded the nocturnal, unilateral, and cumulative myoelectrical activity (microV/min of sleep) of the masseter muscle during the fourth and eighth weeks of the study. The results showed that amitriptyline did not significantly decrease the mean EMG activity (df = 9, alpha = 0.05, paired-t = 0.892, p = 0.3964), nor did it significantly increase the duration of sleep (df = 9, alpha = 0.05, paired-t = 2.140, p = 0.061). The results of this study do not support the administration of 25 mg of amitriptyline per night over a period of four weeks for the management of sleep bruxism.

Using a double-blind and randomized experimental design, ten adult subjects with sleep bruxism were administered amitriptyline (25 mg/night) and placebo (25 mg/night), each compound over a period of one week. Neither the intensities and locations of pains nor the nocturnal masseteric electromyographic activities were significantly affected by the tricyclic antidepressant. In fact, intake of amitriptyline was unpredictably associated with either an increase or a decrease in masseteric electromyographic activity (microV.s/min of sleep). On the basis of this study, small doses of amitriptyline cannot be recommended for the control of sleep bruxism and associated discomforts.