Med/Psych Update

Psychotropic-induced dry mouth: Don’t overlook this potentially serious side effect

Current Psychiatry. 2011 December;10(12):54-58

References

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Acupuncture and electrostimulation are being studied as a treatment for xerostomia. Trials have found acupuncture improves symptoms of xerostomia,^33,34 and 1 study found electrostimulation improved xerostomia in patients with Sjögren’s syndrome.³⁵ Both approaches require more study to confirm their effectiveness.^33-35

Table 2

Managing dry mouth: What to tell patients

Oral hygiene. Tell patients to be diligent in their oral hygiene practices, including brushing and flossing. They should use a toothpaste containing fluoride—preferably one free of sodium lauryl sulfate—and schedule regular dental visits, where they can receive high-fluoride applications or be prescribed high-fluoride prescription toothpastes
Diet. Advise patients to avoid foods high in sucrose content, rinse their mouth with water soon after eating, and drink fluoridated water regularly. Tell them that they may be able to stimulate saliva flow with sugarless gum, candies, and foods such as celery and carrots
Drying agents. Instruct patients to avoid cigarettes, caffeinated beverages, and mouth rinses that contain alcohol. Explain that some patients may benefit from sleeping in a room with a cool air humidifier
Over-the-counter products. Suggest patients try salivary substitutes, which are dispensed in spray bottles, rinses, swish bottles, or oral swab sticks. In addition, products such as dry-mouth toothpaste and moisturizing gels also may help relieve their symptoms

Related Resources

Persson K, Axtelius B, Söderfeldt B, et al. Monitoring oral health and dental attendance in an outpatient psychiatric population. J Psychiatr Ment Health Nurs. 2009;16(3):263-271.
Keene JJ Jr, Galasko GT, Land MF. Antidepressant use in psychiatry and medicine: importance for dental practice. J Am Dent Assoc. 2003;134(1):71-79.

Drug Brand Names

Alprazolam • Xanax
Amlodipine • Norvasc
Bupropion • Wellbutrin, Zyban
Cevimeline • Evoxac
Clonidine • Catapres, Kapvay, others
Esomeprazole • Nexium
Irbesartan • Avapro
Metoprolol • Lopressor, Toprol
Pilocarpine • Salagen
Tolterodine • Detrol
Venlafaxine • Effexor
Zolpidem • Ambien

Disclosure

The authors report no financial relationship with any company whose products are mentioned in this article or with manufacturers of competing products.