Antidepressant use in psychiatry and medicine: importance for dental practice.
BACKGROUND
Many dental patients receive antidepressant therapy. However, antidepressants taken with other drugs may increase the risk of complications that require special dental precautions and care.


METHODS
The authors conducted a retrospective study of 1,800 randomly selected patient records and evaluated the prevalence of using antidepressants and other medications concurrently. They analyzed antidepressant intake relative to drug classification and mechanism of action, age, sex and associated potential for clinical complications such as xerostomia, orthostatic hypotension and interaction with vasoconstrictors. The potential for additive adverse effects between antidepressants and other medications also was analyzed.


RESULTS
Three hundred eighty-one (21 percent) of the 1,800 patient records indicated that patients were being treated with 412 antidepressants. Female subjects out-numbered male subjects by an approximate 2.3:1 ratio. Selective serotonin reuptake inhibitors were most commonly prescribed, followed by tricyclic antidepressants, atypical and third-generation antidepressants, and monoamine oxidase inhibitors. Based on reported medication intake, almost 58 percent of subjects in the antidepressant group were receiving treatment with two or more medications that had the potential for producing xerostomia. Two hundred fifty-seven (67 percent) of the 381 records documented intake of an antidepressant or other medication with orthostatic hypotension potential.


CONCLUSIONS
Three hundred eighty-one patients reported that they were receiving antidepressant therapy for psychiatric and other medical reasons. Potential adverse effects and interactions with other medications have direct implications for dental treatment.


CONCLUSIONS
Patients receiving antidepressant therapy are at risk of developing xerostomia and orthostatic hypotension, as well as experiencing the adverse effects of interaction with vasoconstrictors. Dentists must take appropriate precautions in treating these patients.
Keene
Joseph J
JJ
Department of Applied Dental Medicine, Southern Illinois University, School of Dental Medicine, Alton 62002, USA. jokeene@siue.edu
Galasko
Gail T
GT
Land
Martin F
MF
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000009:adverse effects*; D002648:Child; D017742:Dental Care for Chronically Ill; D004347:Drug Interactions; D005260:Female; D006801:Humans; D007024:Hypotension, Orthostatic / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged; D019338:Polypharmacy; D012189:Retrospective Studies; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects; D014662:Vasoconstrictor Agents / Q000009:adverse effects; D014987:Xerostomia / Q000139:chemically induced*
D000928:Antidepressive Agents; D017367:Selective Serotonin Reuptake Inhibitors; D014662:Vasoconstrictor Agents