Antidepressants in the Treatment of Temporomandibular Joint Disorders (TMD)

• Antidepressants such as duloxetine and amitriptyline can effectively reduce pain and improve the function of the temporomandibular joint.

• Treatment effectiveness increases when medications are combined with non-pharmacological methods, such as arthrocentesis or occlusal splints.

• The best results were observed with duloxetine combined with arthrocentesis and amitriptyline with occlusal splints.

• The findings require further research due to the small sample sizes in the analyzed studies.

Antidepressants and TMD Treatment – New Therapeutic Opportunities

Chronic temporomandibular joint pain (TMD) poses a significant therapeutic challenge. Increasing evidence suggests that the use of antidepressants, particularly in combination therapy, may bring considerable relief to patients.

Researchers from the University of Alberta in Edmonton (Canada), led by Dr. Takara Dei, conducted a review of randomized clinical trials assessing the efficacy of antidepressants in the treatment of temporomandibular joint pain.

Methodology: Review of Available Data

The analysis included seven studies involving 12 to 80 adult patients. The inclusion criterion was chronic temporomandibular joint pain lasting at least three months. Various antidepressants were evaluated, including:

• amitriptyline,

• duloxetine,

• nortriptyline,

• citalopram.

These substances were used either alone or in combination with non-pharmacological methods such as:

• arthrocentesis,

• occlusal splint,

• trigger point injections.

Key Findings: Effectiveness of Medications and Combined Therapies

The studies showed that:

• Duloxetine combined with arthrocentesis was more effective in reducing pain and improving joint function than arthrocentesis alone.

• Amitriptyline combined with an occlusal splint also showed high effectiveness in reducing pain symptoms.

• Nortriptyline with gabapentin led to a significant reduction in pain and muscle tension.

• Citalopram was the least effective and showed no advantage over the therapy used in the control group.

Limitations and the Need for Further Research

The authors emphasize that despite promising results, the current evidence base is limited. The small number of participants in the studies restricts the generalizability of the findings. Further, larger clinical trials are needed to fully assess the efficacy and safety of antidepressants in the treatment of temporomandibular joint disorders.

Summary

• Antidepressants are a promising therapeutic option in the treatment of chronic temporomandibular joint pain (TMD).

• Duloxetine and amitriptyline, especially in combination therapy, show the greatest efficacy.

• Conducting larger clinical studies remains crucial to confirm current findings.

• Combined therapies (pharmacological and non-pharmacological) may become the future standard in TMD treatment.

New Dental Practice: Antidepressants in the Treatment of Temporomandibular Joint Disorders

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