Antidepressants for Gum Disease in Patients With Depression

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Alabama at Birmingham

Must be taking: Antidepressants

Must not be taking: Anti-inflammatories, Nifedipine, Phenytoin

Disqualifiers: Smokers, Immunocompromised, Uncontrolled diabetes, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 2

Duration: 1 week

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores whether antidepressants can reduce gum inflammation in individuals with gum disease who also experience depression. Researchers aim to determine if treating depression improves gum health. The trial includes different groups: participants with gum disease and depression taking antidepressants, those with gum disease and depression not taking antidepressants, and those with gum disease but no depression. This trial may suit individuals with gum disease, with or without depression, who haven't had a recent dental cleaning. As an unphased trial, it offers a unique opportunity to contribute to understanding the potential dual benefits of antidepressants on mental and oral health.

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications, but it does mention that chronic use of anti-inflammatory medications and certain other drugs might affect participation. It's best to discuss your specific medications with the trial team.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that antidepressants can affect gum health in various ways. Some studies suggest that certain antidepressants, such as fluoxetine and imipramine, might improve gum health. However, antidepressants can also cause issues like dry mouth and gum disease. Additionally, a small risk of bleeding problems exists with some antidepressants, though this is rare. Overall, research presents mixed results on safety, highlighting both benefits and potential risks. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it explores the intersection of mental health and oral health, which is a relatively uncharted territory. While treatments like scaling and root planing are standard for gum disease, this study looks at how antidepressants might play a role in managing chronic periodontitis in patients with depression. The trial could uncover whether different classes of antidepressants (SSRIs, NDRIs, SNRIs, tricyclic antidepressants) impact gum disease outcomes, offering a holistic approach to treatment. This could potentially lead to more integrated care strategies that address both mental and dental health, improving overall patient well-being.

What evidence suggests that this trial's treatments could be effective for gum disease in patients with depression?

This trial will compare the effects of different antidepressant regimens on gum health in patients with chronic periodontitis. Research has shown that some antidepressants can improve gum health. For instance, studies have found that medications like fluoxetine, imipramine, and desipramine help reduce gum swelling and bone loss in people with gum disease. These antidepressants are linked to better gum health, protecting the bone around teeth. However, some antidepressants, such as SSRIs, might increase the risk of gum disease by affecting bone strength. Overall, while some antidepressants seem promising for gum health, the effects can vary depending on the specific medication. Participants in this trial will be grouped based on their use of antidepressants and presence of depression to assess these effects. ^{2 3 4 5 6}

Are You a Good Fit for This Trial?

This trial is for adults who are patients at the UAB Dental School with moderate to severe gum disease, as defined by specific dental measurements. It's open to those on antidepressants and those not suffering from depression but excludes non-English speakers, smokers, immunocompromised individuals, and anyone taking certain anti-inflammatory drugs or medications that could affect gum health.

Inclusion Criteria

I am on depression medication and have long-term gum disease.

Able to read and understand informed consent document

I have severe gum disease with deep pockets and gum recession.

Exclusion Criteria

I need immediate dental care for a condition.

You smoke or use tobacco products regularly, at least 10 cigarettes per day.

I regularly take anti-inflammatory medication, but not more than 325 mg of aspirin daily.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive antidepressants and undergo periodontal therapy to evaluate the reduction in gingival inflammation

1 week

1 visit (in-person)

Sample Collection

Collection of gingival crevicular fluid, plaque, tissue, and blood serum samples to evaluate inflammatory markers

1 week

1 visit (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Periodontal Surgery

Trial Overview The study is testing if antidepressants can lessen gum inflammation in people with periodontal disease. Participants will undergo standard periodontal surgery while their inflammatory markers are monitored to see if there's a difference between those with and without depression.

How Is the Trial Designed?

Group I: Chronic Periodontitis and Depression Medications Active Control 1 Intervention

Patients with clinically diagnosed depression taking (SSRIs, NDRIs, SNRIs, tricyclic antidepressants) and with chronic periodontitis

Group II: Chronic Periodontitis Active Control 1 Intervention

Patients without depression, not taking any antidepressants and with chronic periodontitis

Group III: Chronic Periodontitis without Depression Medications Active Control 1 Intervention

Patients with clinically diagnosed depression not taking any antidepressants (SSRIs NDRIs, SNRIs and Tricyclic antidepressants) and with chronic periodontitis

Who Is Running the Clinical Trial?

University of Alabama at Birmingham

Lead Sponsor

Trials

1,677

Recruited

2,458,000+

Citations

1. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/39124790/

The Effects of Antidepressant Drugs on the Periodontium in ... Most trials showed improvements in periodontal health, especially with fluoxetine, but also with imipramine, desipramine, desvenlafaxine and tianeptine.

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11594724/

Oral Manifestations in Patients in Treatment with ... SSRIs, for example, are associated with increased periodontal disease risk due to their effects on bone density and inflammation [10].

3. mdpi.com mdpi.com/2077-0383/13/15/4524

Periodontitis and Depressive Disorders: The Effects of ... Most trials showed improvements in periodontal health, especially with fluoxetine, but also with imipramine, desipramine, desvenlafaxine and tianeptine.

4. sciencedirect.com sciencedirect.com/science/article/pii/S0020653925031909

Evaluating the Effects of Selective Serotonin Reuptake ... This study suggests that SSRIs may impair osteogenic differentiation of PDLSCs by suppressing IGF-1 and HGF signaling pathways. These findings provide ...

5. researchgate.net researchgate.net/publication/390600481_Influence_of_antidepressant_use_on_periodontal_status_a_systematic_review_and_meta-analysis

Influence of antidepressant use on periodontal status Tianeptine, desipramine, imipramine, and fluoxetine effectively reduced alveolar bone loss in experimental periodontitis. Furthermore, ...

6. mdpi.com mdpi.com/2077-0383/14/17/6140

Systematic Review on Antidepressant Use and Bleeding ... Only one retrospective study, which did not match the inclusion criteria, identified a 1% incidence of bleeding complications in users of selective serotonin ...