Atomoxetine-induced dose-dependent bruxism in a child patient

Bruxism is characterized by grinding or clenching of the teeth, which results in characteristic grinding sounds, abnormal tooth wear and jaw and muscle pain. It can be classified as primary/idiopathic or secondary/ iatrogenic bruxism, which is associated with medication or medical diseases. Atomoxetine is the first non-stimulant medication for the treatment of Attention deficit hyperactivity disorder. It is a generally safe and well-tolerated drug. Most common adverse reactions include nausea, vomiting, fatigue, decreased appetite, abdominal pain, and somnolence. We report a case of dose-dependent bruxism induced by atomoxetine, which was observed in a child with Attention deficit hyperactivity disorder and adjustment disorder with anxiety. Atomoxetine treatment has been started at a dose of 18 mg/day and then increased up to 60 mg/day. A month later, the frequency and severity of these complaints were increased. Nevertheless, atomoxetine dose was tapered down to 40 mg/day and was continued in this way. At the meeting held a month after the disappearance of bruxism, there was no decline in improvement of ADHD symptoms.