Tricyclic antidepressants, including specifically amitriptyline, have been suggested to be effective in alleviating pain in chronic pain syndromes and in reducing bruxism by an unknown mechanism. None of the distractors have been shown to decrease bruxism. SSRI’s may increase bruxism.
Tricylcic antidepressants (elavil) prevent the reuptake of catecholamines. Ketamine has sympathomimetic effects and will be associated with an increase in heart rate and blood pressure. These effects will be potentiated by the tricyclic antidepressant and compounded by the patient’s history of hypertension.
