Drugs That Cause Xerostomia

Over 1,800 prescribed medications list dry mouth as a common symptom. This article explores the most prevalent drug-induced causes of xerostomia so patients can identify whether their medication might be responsible for their symptoms.

What is xerostomia?

Xerostomia, or dry mouth, results from inadequate salivary gland function. Saliva serves multiple purposes: lubricating the oral cavity, removing food particles, controlling plaque, aiding digestion, and facilitating swallowing.

Medical conditions causing xerostomia include Sjogren's syndrome, rheumatoid arthritis, diabetes, salivary gland removal, hormonal imbalances, smoking, cystic fibrosis, sleep apnea, hypothyroidism, and systemic lupus erythematosus. Drug-induced xerostomia persists as long as use of the medication continues.

Symptoms include bad breath, taste disorders, painful tongue, lip inflammation, and frequent gum disease. The condition affects at least 10% of the global population, more commonly in women.

Diagnosis typically involves medical history review, medication inventory (prescribed and over-the-counter), physical examination, and sometimes blood tests. Treatment emphasizes adequate water intake and artificial saliva products. Untreated xerostomia risks tooth decay, mouth sores, gingivitis, cavities, oral yeast infections, and cracked lips. Daily fluoride treatments provide additional protection.

Most Common Drugs Causing Xerostomia

• Antidepressants: Used for depression, eating disorders, OCD, and chronic pain. Tricyclic antidepressants and lithium most commonly cause dry mouth.
• Atropine and Scopolamine: Treat gastrointestinal and bladder spasms, colitis, diverticulitis, motion sickness, and renal colic. These medications reduce the secretions of many organs, including the salivary glands.
• Antihistamines: Treat allergies, atopic dermatitis, and hives. Commonly implicated medications include Allegra, Dimetane, Tavist, Palgic, and Atarax.
• Opioids: Manage moderate to severe pain. Associated opioids include codeine, Vicodin, Lorcet, Demerol, morphine, and OxyContin.
• Antihypertensives: Control high blood pressure; dry mouth is a frequently reported side effect.
• Antipsychotics: Treat schizophrenia and bipolar disorder; among the most common drug-induced xerostomia causes.
• Antibiotics: Fight bacterial infections; xerostomia may occur as a side effect.
• Cannabinoids: Used for multiple sclerosis, neuropathic pain, AIDS, and advanced cancer to manage pain and nausea.

Conclusion

Medication represents a major xerostomia cause. Patients experiencing dry mouth should consult their physician about potential medication switching or alternative treatments.