Injured temporomandibular joint associated with fluoxetine-monotherapy-induced repeated yawning

Drug-Induced Yawning—A Review

Objective:

To review the current literature on drug-induced yawning.

Data Sources:

Literature was accessed through MEDLINE/PubMed (1996-July 2011), International Pharmaceutical Abstracts (1997-July 2011), and EMBASE, using the search terms yawning, drug-induced yawning, and adverse drug reactions.

Study Selection and Data Extraction:

Relevant clinical trials and case reports were selected and included to present background information. Bibliographies of all relevant articles were reviewed for additional citations.

Data Synthesis:

Yawning is a common stereotype behavior with unknown physiologic function that occurs in most vertebrates and humans as early as 15 weeks of intrauterine life. Yawning Is under the control of several neurotransmitters and neuropeptides, Including dopamine, serotonin, oxytocin, and acetylcholine. Among drugs, antidepressants, opioids, dopaminergic agents, benzodiazepines, and induction agents are the main pharmacologic classes associated with yawning.

Conclusions:

Yawning is rarely a serious adverse reaction and is not frequently listed in the drug summary. Most available data are based on case reports, small studies, and older literature. Clinicians should be aware of the agents commonly triggering this behavior.

Do your patients suffer from excessive yawning?

OBJECTIVE

Yawning has been described in relation to drugs such as serotonin reuptake inhibitors, levodopa, dopamine agonists, MAO B inhibitor, morphine, methadone, buprenorphine, dextromethorphan, benzodiazepine, lidocaine, and flecaine. This is a report of two patients, on long-term escitalopram therapy (more than 8 weeks) with stable dosing, who presented excessive yawning. Escitalopram is widely used in major depressive disorder and generalized anxiety disorder.

METHOD

A clinical description of two cases.

RESULTS

Two females (62 and 59 years old, respectively) developed excessive daytime yawning. It was not associated with sedation or a feeling of needing sleep. The dosage was reduced and yawning disappeared some hours later. The patients' depression did not recur.

CONCLUSION

Yawning has been described in relation to different selective serotonin reuptake inhibitors and remitted following their discontinuation; it is interesting that the reported yawning in these two cases disappeared with the reduction of dosage, rather than the interruption of treatment.