Pharmacotherapy for sleep bruxism

This Cochrane review found only seven eligible randomised crossover trials of drug treatment for sleep bruxism, each with just 7 to 16 participants. Amitriptyline did not reduce masseter EMG activity (standardised mean difference -0.28, 95% CI -0.91 to 0.34, p = 0.37), and bromocriptine, propranolol, levodopa, clonidine and L-tryptophan all produced imprecise results consistent with benefit, no difference or harm. Adverse effects were common: 5 of 10 on amitriptyline had drowsiness, morning grogginess, insomnia or dry mouth versus 0 of 10 on placebo, 7 of 16 on propranolol had moderate-to-severe dry mouth versus 2 of 16, and 3 of 16 on clonidine had prolonged morning low blood pressure. The authors conclude there is insufficient evidence that any drug treats sleep bruxism.