# Impact of selective serotonin reuptake inhibitors on major salivary glands and mandibular alveolar bone; a histological, histochemical and biochemical study

## TL;DR

This study finds that long-term use of the SSRI Cipralex may damage salivary glands and alveolar bone in rats, suggesting potential oral health risks for patients.

## Contribution

The study is among the first to investigate the impact of SSRIs on salivary glands and alveolar bone using histological and biochemical methods.

## Key findings

- Cipralex-treated rats showed significant deterioration in salivary gland architecture and signs of alveolar bone resorption.
- There was a statistically significant decrease in newly formed collagen in the alveolar bone of treated rats.
- Serum IL-1β levels were significantly reduced in the Cipralex group, while TNF-α levels remained unchanged.

## Abstract

Selective serotonin reuptake inhibitors (SSRIs) are a novel type of antidepressant (AD) that can be used as a first-line treatment for depression and other mental illnesses. Long-term AD use is becoming more frequent, with many people continuing to get therapy for extended periods of time. This surge has been linked to a number of health concerns, including an increased risk of fractures, lower bone mineral density in young adults, and a significantly elevated risk of dry mouth, all of which can have a negative impact on dental health and general quality of life. This study aimed to evaluate the effect of Cipralex (SSRI) on the histological structure of major salivary glands and alveolar bone, as well as its impact on pro-inflammatory cytokines interleukin 1 beta (IL-1β) and Tumor necrosis factor alpha (TNF-α).

18 rats were randomly separated into two groups (n = 9 each): a control group and a Cipralex-treated group receiving 10 mg/kg/day orally by gavage for four weeks. Major salivary glands and mandibular molar region specimens were collected for histological evaluation using hematoxylin and eosin( H&E) staining. Alveolar bone specimens were stained with Masson’s trichrome (MT), and histomorphometric analysis of newly formed collagen area percentage was performed using ImageJ software. Serum IL-1β and TNF-α levels were quantified using enzyme-linked immunosorbent assay (ELISA).

The Cipralex group’s histological analysis showed that the architecture of the normal major SGs had deteriorated notably, and there were indications of bone resorption in the alveolar bone. There was a statistically significant decrease in the amount of newly produced collagen compared with controls (p < .05). Biochemical analysis showed a significant decrease in serum IL-1β levels in the Cipralex group (245.22 ± 5.04) versus control (262.67 ± 4.88), while TNF-α levels did not differ significantly between groups ( control ; 693.88 ± 8.65, cipralex; 695.84 ± 7.06) p = .607 .

Long-term use of Cipralex may compromise the integrity of the salivary glands and raise the possibility of alveolar bone resorption. These results highlight the significance of dental and periodontal monitoring in patients undergoing long-term antidepressant treatment and emphasize possible oral health problems linked to long-term SSRI therapy.