Effectiveness of Pregabalin for Treatment of Burning Mouth Syndrome

Amasyalı, Saliha Yeter; Gürses, Aslı Akyol; Aydın, Osman Nuri; Akyol, Ali

doi:10.9758/cpn.2019.17.1.139

Cited by 11 publications

(5 citation statements)

References 16 publications

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“…Psychotropic treatment combining agents with different pharmacologic actions appears to offer greater efficacy than monotherapy. 14 In the present case, modulation of dopamine D2 receptors, serotonin receptors, and GABA receptors may have been effective. The success of this pharmacological therapy, which targets a variety of receptors, would be attributed to complex interaction within the cortico‐basal ganglia‐thalamus‐cortical loops.…”

Section: Discussionmentioning

confidence: 64%

“…In summary, perospirone brought adequate stabilization of dopaminergic circuits in basal ganglia involving serotoninergic and GABA systems modulated by amitriptyline and clonazepam. Psychotropic treatment combining agents with different pharmacologic actions appears to offer greater efficacy than monotherapy 14 . In the present case, modulation of dopamine D2 receptors, serotonin receptors, and GABA receptors may have been effective.…”

Section: Discussionmentioning

confidence: 65%

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The effective perospirone augmentation with clonazepam for treatment‐resistant burning mouth syndrome: A case report

Watanabe,

Takao,

Maeda

et al. 2024

Neuropsychopharm Rep

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Burning mouth syndrome (BMS) is characterized by burning sensations in the oral region without corresponding abnormalities and is often accompanied by uncomfortable sensations. Herein, we present cases of BMS in which the remaining uncomfortable sensations improved with perospirone augmentation with clonazepam. Case 1: A 61‐year‐old man complained of a burning pain in his tongue, a sensation of dryness and discomfort as if his tongue was sticking to a palatal plate. With the diagnosis of BMS, psychopharmacotherapy was initiated with amitriptyline. At the dose of amitriptyline 50 mg, the pain lessened but uncomfortable sensations persisted. Further attempts to alleviate symptoms by combining aripiprazole with amitriptyline, aripiprazole with mirtazapine, or aripiprazole with clonazepam were limited; however, nearly all symptoms were relieved by a combination of perospirone 8.0 mg with clonazepam 1.5 mg. Case 2: A 51‐year‐old woman complained of a burning sensation along with oral dryness and crumb‐like feeling on her tongue. She was diagnosed with BMS and began treatment with amitriptyline. Her burning sensation improved at the dose of 25 mg, but uncomfortable sensations persisted. Augmentation of amitriptyline with aripiprazole, aripiprazole either with valproate, mirtazapine, or clonazepam failed to produce a significant improvement. However, a regimen of perospirone 6.0 mg and clonazepam 1.5 mg relieved the crumb‐like sensation and pain and culminated in a stabilized condition. The reported cases suggested that multiple approaches targeting the dopaminergic circuit in basal ganglia involving the serotoninergic and GABA systems, through the administration of perospirone with clonazepam is an effective adjunctive treatment for the remaining uncomfortable sensations in patients with BMS.

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Section: Discussionmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 65%

The effective perospirone augmentation with clonazepam for treatment‐resistant burning mouth syndrome: A case report

Watanabe,

Takao,

Maeda

et al. 2024

Neuropsychopharm Rep

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“…2,3 However, no standard consensus has been reached for treatment, either pharmacologic or nonpharmacologic. 4 Treatment options include antidepressants, benzodiazepines, antipsychotics, anticonvulsants, analgesics, hormone replacement therapy, and psychotherapy, but serotonin-increasing drugs such as tricyclic antidepressant and selective serotonin reuptake inhibitors are most commonly used. 5 Amitriptyline, a tricyclic antidepressant, is commonly used to treat chronic unexplained orofacial pain including BMS in Japan, 6 but it may be ineffective or worse in some BMS patients.…”

mentioning

confidence: 99%

“…The incidence is reported to be 0.7% to 10% and is not uncommon 2,3 . However, no standard consensus has been reached for treatment, either pharmacologic or nonpharmacologic 4 . Treatment options include antidepressants, benzodiazepines, antipsychotics, anticonvulsants, analgesics, hormone replacement therapy, and psychotherapy, but serotonin-increasing drugs such as tricyclic antidepressant and selective serotonin reuptake inhibitors are most commonly used 5 .…”

mentioning

confidence: 99%

QTc Shortening on Electrocardiogram With Amitriptyline May Indicate No Effect on Pain Relief in Burning Mouth Syndrome

Nagamine,

Watanabe,

Toyofuku

2024

Clin Neuropharm

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Objective Burning mouth syndrome (BMS) is an intractable chronic pain disorder characterized by a burning sensation without organic abnormalities in the oral mucosa. Amitriptyline may be effective for BMS or, conversely, may exacerbate pain. QTc is necessary for monitoring psychotropic adverse effects, but it is not known if it is a predictor of efficacy for BMS. We investigated the efficacy of amitriptyline in BMS and its effect on QTc. Methods Visual analog scale and electrocardiogram were examined before and 1 month after treatment in 51 consecutive patients diagnosed with BMS according to the International Classification of Headache Disorders, Third Edition (ICHD-3), criteria and treated with amitriptyline. Results There were 26 amitriptyline responders and 25 nonresponders, with no differences in age, sex, and amitriptyline dosage. Amitriptyline responders showed little change in QTc, whereas nonresponders showed a trend toward significantly shorter QTc. Changes in visual analog scale correlated statistically significantly with changes in QTc (Spearman rank correlation coefficient: 0384; P = 0.0054). The degree of pain tended to worsen with QTc shortening. Conclusion Amitriptyline provides analgesia in about half of BMS patients, but some BMS patients have worse pain with amitriptyline. Not only do changes in the QTc detect amitriptyline adverse effects with prolongation, but also, conversely, its shortening predicts amitriptyline ineffectiveness.

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“…BMS remains a poorly understood condition and is considered to have a multifactorial etiology . Recent studies have explained that several neuropathic mechanisms are involved in the pathophysiology of primary BMS.…”

mentioning

confidence: 99%