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Effects of Pregabalin in Primary Burning Mouth Syndrome Patients Unresponsive to Topical Clonazepam Treatment: A Retrospective Pilot Study

  • Heo, Jun-Young (Department of Oral Medicine, Pusan National University Dental Hospital, Dental Research Institute) ;
  • Jeon, Jae-Woo (Department of Oral Medicine, School of Dentistry, Pusan National University, Dental Research Institute) ;
  • Ok, Soo-Min (Department of Oral Medicine, School of Dentistry, Pusan National University, Dental Research Institute) ;
  • Jeong, Sung-Hee (Department of Oral Medicine, School of Dentistry, Pusan National University, Dental Research Institute) ;
  • Ahn, Yong-Woo (Department of Oral Medicine, School of Dentistry, Pusan National University, Dental Research Institute)
  • Received : 2016.02.15
  • Accepted : 2016.03.09
  • Published : 2016.03.30

Abstract

Purpose: To investigate the efficacy of pregabalin for patients with primary burning mouth syndrome (BMS) who are unresponsive to topical clonazepam therapy. Methods: By searching the clinical electronic records from the Department of Oral Medicine, Pusan National University Dental Hospital from 2012 to 2014, a retrospective analysis was performed on patients with primary BMS who were treated with topical clonazepam therapy during this period. Of the patients who were unresponsive to this therapy, 19 patients who were subsequently treated with pregabalin were included in the study. A pain assessment was performed using the 11-point numerical rating scale at first visit, following topical clonazepam therapy, and again after pregabalin therapy. The treatment outcomes were statistically analyzed using the Wilcoxon signed rank test. Results: Following additional pregabalin administration, the mean pain score was slightly reduced. A total of 7 patients reported a marked response (>50% pain reduction), and 3 patients reported a slight reduction in pain. Pain reduction following pregabalin therapy was statistically significant (p<0.05). Conclusions: Pregabalin has a slight therapeutic effect on patients with primary BMS. Therefore, we recommend pregabalin as an alternative drug for BMS patients who are unresponsive to topical clonazepam therapy.

Keywords

References

  1. Gurvits GE, Tan A. Burning mouth syndrome. World J Gastroenterol 2013;19:665-672. https://doi.org/10.3748/wjg.v19.i5.665
  2. Lipton JA, Ship JA, Larach-Robinson D. Estimated prevalence and distribution of reported orofacial pain in the United States. J Am Dent Assoc 1993;124:115-121.
  3. Tammiala-Salonen T, Hiidenkari T, Parvinen T. Burning mouth in a Finnish adult population. Community Dent Oral Epidemiol 1993;21:67-71. https://doi.org/10.1111/j.1600-0528.1993.tb00723.x
  4. Bergdahl M, Bergdahl J. Burning mouth syndrome: prevalence and associated factors. J Oral Pathol Med 1999;28:350-354.
  5. Minguez-Sanz MP, Salort-Llorca C, Silvestre-Donat FJ. Etiology of burning mouth syndrome: a review and update. Med Oral Patol Oral Cir Bucal 2011;16:e144-e148.
  6. Lamey PJ, Hobson RS, Orchardson R. Perception of stimulus size in patients with burning mouth syndrome. J Oral Pathol Med 1996;25:420-423. https://doi.org/10.1111/j.1600-0714.1996.tb00290.x
  7. Ship JA, Grushka M, Lipton JA, Mott AE, Sessle BJ, Dionne RA. Burning mouth syndrome: an update. J Am Dent Assoc 1995;126:842-853. https://doi.org/10.14219/jada.archive.1995.0305
  8. Scala A, Checchi L, Montevecchi M, Marini I, Giamberardino MA. Update on burning mouth syndrome: overview and patient management. Crit Rev Oral Biol Med 2003;14:275-291. https://doi.org/10.1177/154411130301400405
  9. Danhauer SC, Miller CS, Rhodus NL, Carlson CR. Impact of criteria-based diagnosis of burning mouth syndrome on treatment outcome. J Orofac Pain 2002;16:305-311.
  10. Patton LL, Siegel MA, Benoliel R, De Laat A. Management of burning mouth syndrome: systematic review and management recommendations. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007;103(Suppl):S39.e1-e13. https://doi.org/10.1016/j.tripleo.2005.11.022
  11. Jaaskelainen SK, Forssell H, Tenovuo O. Abnormalities of the blink reflex in burning mouth syndrome. Pain 1997;73:455-460. https://doi.org/10.1016/S0304-3959(97)00140-1
  12. Forssell H, Jaaskelainen S, Tenovuo O, Hinkka S. Sensory dysfunction in burning mouth syndrome. Pain 2002;99:41-47. https://doi.org/10.1016/S0304-3959(02)00052-0
  13. Gao S, Wang Y, Wang Z. Assessment of trigeminal somatosensory evoked potentials in burning mouth syndrome. Chin J Dent Res 2000;3:40-46.
  14. Lauria G, Majorana A, Borgna M, et al. Trigeminal small-fiber sensory neuropathy causes burning mouth syndrome. Pain 2005;115:332-337. https://doi.org/10.1016/j.pain.2005.03.028
  15. Lauria G. Small fibre neuropathies. Curr Opin Neurol 2005;18:591-597. https://doi.org/10.1097/01.wco.0000177330.35147.70
  16. Hagelberg N, Forssell H, Rinne JO, et al. Striatal dopamine D1 and D2 receptors in burning mouth syndrome. Pain 2003;101:149-154. https://doi.org/10.1016/S0304-3959(02)00323-8
  17. Jaaskelainen SK, Rinne JO, Forssell H, et al. Role of the dopaminergic system in chronic pain: a fluorodopa-PET study. Pain 2001;90:257-260. https://doi.org/10.1016/S0304-3959(00)00409-7
  18. Albuquerque RJ, de Leeuw R, Carlson CR, Okeson JP, Miller CS, Andersen AH. Cerebral activation during thermal stimulation of patients who have burning mouth disorder: an fMRI study. Pain 2006;122:223-234. https://doi.org/10.1016/j.pain.2006.01.020
  19. Jaaskelainen SK. Pathophysiology of primary burning mouth syndrome. Clin Neurophysiol 2012;123:71-77. https://doi.org/10.1016/j.clinph.2011.07.054
  20. de Moraes M, do Amaral Bezerra BA, da Rocha Neto PC, et al. Randomized trials for the treatment of burning mouth syndrome: an evidence-based review of the literature. J Oral Pathol Med 2012;41:281-287. https://doi.org/10.1111/j.1600-0714.2011.01100.x
  21. Ko JY, Kim MJ, Lee SG, Kho HS. Outcome predictors affecting the efficacy of clonazepam therapy for the management of burning mouth syndrome (BMS). Arch Gerontol Geriatr 2012;55:755-761. https://doi.org/10.1016/j.archger.2011.10.001
  22. Martin WJ, Forouzanfar T. The efficacy of anticonvulsants on orofacial pain: a systematic review. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011;111:627-633. https://doi.org/10.1016/j.tripleo.2011.01.033
  23. Argoff CE, Backonja MM, Belgrade MJ, et al. Consensus guidelines: treatment planning and options. Diabetic peripheral neuropathic pain. Mayo Clin Proc 2006;81(4 Suppl):S12-S25. https://doi.org/10.1016/S0025-6196(11)61475-4
  24. Zakrzewska JM, Forssell H, Glenny AM. Interventions for the treatment of burning mouth syndrome. Cochrane Database Syst Rev 2005;(1):CD002779.
  25. Sardella A, Lodi G, Demarosi F, Bez C, Cassano S, Carrassi A. Burning mouth syndrome: a retrospective study investigating spontaneous remission and response to treatments. Oral Dis 2006;12:152-155. https://doi.org/10.1111/j.1601-0825.2005.01174.x
  26. Woda A, Navez ML, Picard P, Gremeau C, Pichard-Leandri E. A possible therapeutic solution for stomatodynia (burning mouth syndrome). J Orofac Pain 1998;12:272-278.
  27. Gremeau-Richard C, Woda A, Navez ML, et al. Topical clonazepam in stomatodynia: a randomised placebo-controlled study. Pain 2004;108:51-57. https://doi.org/10.1016/j.pain.2003.12.002
  28. Grushka M, Epstein J, Mott A. An open-label, dose escalation pilot study of the effect of clonazepam in burning mouth syndrome. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1998;86:557-561. https://doi.org/10.1016/S1079-2104(98)90345-6
  29. Heckmann SM, Kirchner E, Grushka M, Wichmann MG, Hummel T. A double-blind study on clonazepam in patients with burning mouth syndrome. Laryngoscope 2012;122:813-816. https://doi.org/10.1002/lary.22490
  30. Amos K, Yeoh SC, Farah CS. Combined topical and systemic clonazepam therapy for the management of burning mouth syndrome: a retrospective pilot study. J Orofac Pain 2011;25:125-130.
  31. Gremeau-Richard C, Dubray C, Aublet-Cuvelier B, Ughetto S, Woda A. Effect of lingual nerve block on burning mouth syndrome (stomatodynia): a randomized crossover trial. Pain 2010;149:27-32. https://doi.org/10.1016/j.pain.2009.11.016
  32. de Tommaso M, Lavolpe V, Di Venere D, et al. A case of unilateral burning mouth syndrome of neuropathic origin. Headache 2011;51:441-444. https://doi.org/10.1111/j.1526-4610.2010.01754.x
  33. Lopez V, Alonso V, Marti N, Calduch L, Jorda E. Marked response of burning mouth syndrome to pregabalin treatment. Clin Exp Dermatol 2009;34:e449-e450. https://doi.org/10.1111/j.1365-2230.2009.03493.x
  34. Heckmann SM, Heckmann JG, Ungethüm A, Hujoel P, Hummel T. Gabapentin has little or no effect in the treatment of burning mouth syndrome: results of an open-label pilot study. Eur J Neurol 2006;13:e6-e7.
  35. White TL, Kent PF, Kurtz DB, Emko P. Effectiveness of gabapentin for treatment of burning mouth syndrome. Arch Otolaryngol Head Neck Surg 2004;130:786-788. https://doi.org/10.1001/archotol.130.6.786