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What Causes Freezing Of Face And Pain In Jaw?
Question: Dear Doctor, I am having Anxiety and Depression since childhood. I am male and age 42 yrs having sedentary job(Government). My weight is 82 kg and height 5'10". I took almost all all therapies like muscle relaxtion, rtms, psychotherapy, hypnotherapy, yoga etc., from many psycholigists and psychiatrists and almost relieved from many of the problems.
Presently I am taking under supervision of Psychiatrist Paxidep CR 25 mg 1 tab and rivotril 2mg 1 tab and unicobol forte one tab. My present problem is that
1)Freezing of face and pain in the jaw (means unable to express facial feelings freely and pain in the jaw). This problem is hampering my life. Some of the Doctors are saying this is because of Rivotril but I am taking Rivotril since 2000. But this problem started since 1996. Kindly suggest me this is the problem because I am facing problem in the social situations.
Finally Kindly advice only medicines for this and any facial exercises.
Presently I am taking under supervision of Psychiatrist Paxidep CR 25 mg 1 tab and rivotril 2mg 1 tab and unicobol forte one tab. My present problem is that
1)Freezing of face and pain in the jaw (means unable to express facial feelings freely and pain in the jaw). This problem is hampering my life. Some of the Doctors are saying this is because of Rivotril but I am taking Rivotril since 2000. But this problem started since 1996. Kindly suggest me this is the problem because I am facing problem in the social situations.
Finally Kindly advice only medicines for this and any facial exercises.
Brief Answer:
You may continue Rivotril, augmentation with Trihexyphenidyl is recommended
Detailed Answer:
Hi, Welcome to HCM.
It is a wise step to discuss your medical issues here.
I am glad to know that you are doing well under guidance of your treating psychiatrist.
The problem you are facing at present (pain in jaw and difficulty in facial expression) does not appear due to Rivotril (Clonazepam), rather it may help in this condition. This may be due to extrapyramidal side effects of Tablet Paroxetine (Paxidep CR) you are taking. Paroxetine is known to produce this side effect in some patients.
Do you also have tremors of hand/ rigidity of movement elsewhere also? If yes it goes more towards this side effect.
Since your anxiety and depressive symptoms are well controlled with current medications, I do not want you to stop the medicine.
In my clinical practice I usually treat such a problem with addition of another medicine named Trihexyphenidyl (Pacitane). It is useful in reducing the extrapyramidal side effect of this medication.
I suggest you to discuss this issue with your treating psychiatrist who may consider adding this drug in your current therapy.
I welcome any follow up query from your side.
You may continue Rivotril, augmentation with Trihexyphenidyl is recommended
Detailed Answer:
Hi, Welcome to HCM.
It is a wise step to discuss your medical issues here.
I am glad to know that you are doing well under guidance of your treating psychiatrist.
The problem you are facing at present (pain in jaw and difficulty in facial expression) does not appear due to Rivotril (Clonazepam), rather it may help in this condition. This may be due to extrapyramidal side effects of Tablet Paroxetine (Paxidep CR) you are taking. Paroxetine is known to produce this side effect in some patients.
Do you also have tremors of hand/ rigidity of movement elsewhere also? If yes it goes more towards this side effect.
Since your anxiety and depressive symptoms are well controlled with current medications, I do not want you to stop the medicine.
In my clinical practice I usually treat such a problem with addition of another medicine named Trihexyphenidyl (Pacitane). It is useful in reducing the extrapyramidal side effect of this medication.
I suggest you to discuss this issue with your treating psychiatrist who may consider adding this drug in your current therapy.
I welcome any follow up query from your side.
Above answer was peer-reviewed by :
Dr. Shanthi.E
Doctor, I am thankful to you for your prompt response. Rigidity and freezing of face is not because of paxidep as i told you this problem I am facing since 1996 prior to taking medicines.
Second thing I forgot to tell you that I have a moodswing problem. You know I am going/ went all therapies kindly suggest any medicines to stop this moodswings.
Kinldy suggest medicines for these two problems 1) stiffness in the fact/jaw 2) moodswings.
Kindly give me answer as early as possible so that I want to close the discussion please.
Second thing I forgot to tell you that I have a moodswing problem. You know I am going/ went all therapies kindly suggest any medicines to stop this moodswings.
Kinldy suggest medicines for these two problems 1) stiffness in the fact/jaw 2) moodswings.
Kindly give me answer as early as possible so that I want to close the discussion please.
Brief Answer:
Sodium Divalproex is a good mood stabliser
Detailed Answer:
Hi, welcome back.
Thanks for updates about your health status. Now I can help you in a better way.
Have you ever consulted an orthopedician/maxillfacial surgeon for jaw stiffness ? Temporomandibular arthritis/arthropathy may be one of the important cause which has to be ruled out.
For mood swings a mood stabilizer may be added to your therapy. Sodium Divalproex is a good option with fair safety profile and good control over mood swings.
Secondly if rigidity and stiffness of face is from long time even before starting of medication, in absence of a temporomandibular joint disease, then it may be either "Facial Dystonia" or features of "Parkinsonism". In this case also Trihexyphenidyl will definitely help.
You did not answer about my query yet. I ask again; please tell me about presence of tremors, rigidity of other joints especially smaller joints like fingers and wrist, difficulty in walking etc if present in your case in addition to facial symptoms. This will further help me reaching a conclusion.
I am awaiting your reply.
Sodium Divalproex is a good mood stabliser
Detailed Answer:
Hi, welcome back.
Thanks for updates about your health status. Now I can help you in a better way.
Have you ever consulted an orthopedician/maxillfacial surgeon for jaw stiffness ? Temporomandibular arthritis/arthropathy may be one of the important cause which has to be ruled out.
For mood swings a mood stabilizer may be added to your therapy. Sodium Divalproex is a good option with fair safety profile and good control over mood swings.
Secondly if rigidity and stiffness of face is from long time even before starting of medication, in absence of a temporomandibular joint disease, then it may be either "Facial Dystonia" or features of "Parkinsonism". In this case also Trihexyphenidyl will definitely help.
You did not answer about my query yet. I ask again; please tell me about presence of tremors, rigidity of other joints especially smaller joints like fingers and wrist, difficulty in walking etc if present in your case in addition to facial symptoms. This will further help me reaching a conclusion.
I am awaiting your reply.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Dear Doctor, I don't have any other problems except this. Neither I have tremors, joint paints or difficulty in walking. Physically I am absolutely fit and my height 5'10" and weight 80 kg absolutely, Healthy and Sexually nothing I am perfectly alright and having no problem. I don't have any other problems except mentioned above.
Finally kindly tell me for frozen face, stiffness in the jaws etc. I can use Paciten. If so, what is the dosage?
Second for moodswings Divolproex sodium, if so what is the dosage.
Thanking you,
Finally kindly tell me for frozen face, stiffness in the jaws etc. I can use Paciten. If so, what is the dosage?
Second for moodswings Divolproex sodium, if so what is the dosage.
Thanking you,
Brief Answer:
Pacitane and Divalproex may be used.
Detailed Answer:
Dear XXXX.
Thanks for follow up query.
Pacitane comes in 2 mg tablet form. Twice a day is a fair dose.
Unfortunately current law does not allow a prescription of mood stablizers online and so is the dispensing of these drugs over the counter without a physical prescription. You should speak to your current Psychiatrist for a safe dose. I am sure this will help you.
Pacitane and Divalproex may be used.
Detailed Answer:
Dear XXXX.
Thanks for follow up query.
Pacitane comes in 2 mg tablet form. Twice a day is a fair dose.
Unfortunately current law does not allow a prescription of mood stablizers online and so is the dispensing of these drugs over the counter without a physical prescription. You should speak to your current Psychiatrist for a safe dose. I am sure this will help you.
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Shanthi.E
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