Burning Mouth Syndrome Responsive to Duloxetine: (A Case Report) (P07.273)

Abstract

Objective: Burning Mouth Syndrome (BMS) or Glossodynia (also known as “Burning tongue” and “Orodynia”) is a condition characterized by a burning or tingling sensation on the lips, tongue, or entire mouth. It is typically a chronic, idiopathic, intraoral mucosal pain condition in the absence of specific oral lesions and systemic disease. CASE : I would like to report a case of a 60-year-old woman in good health with history of insomnia for 2 years taking only Zolpidem (Ambien) 10 mg at night and Paroxetine 37.5 mg daily at home. She stopped taking Paroxetine (Paxil) abruptly 1.5 years earlier for empirical treatment of depression. Since this time, she complained of her tongue being ripped and her mouth feeling that it is “on fire.” She was given a clinical diagnosis of Burning Mouth Syndrome with Sjogren9s syndrome in the differential. She was started on Duloxetine (Cymbalta) 60 mg po daily, resulting in a complete remission of her symptoms including clinical depression. Her burning mouth resolved after 1 week of starting Duloxetine 30 mg po daily and her clinical depression resolved after 4 weeks of taking Duloxetine 60 mg po daily. Her quality of life and level of functioning went back to her baseline. Background The exact pathogenesis of BMS is not clear. Possible causes include nutritional deficiencies, chronic anxiety or depression, type 2 diabetes, menopause, oral disorders such as thrush or dry mouth, or an underlying neuropathic mechanism. It is possible that there is a dysfunction in the trigeminal nociceptive pathways at the level of the peripheral and/or central nervous system. Conclusions: Duloxetine might be a useful and effective treatment of BMS in addition to its other uses with Major Depression, Diabetic Neuropathy, Generalized Anxiety Disorder, Fibromyalgia, and Chronic Musculoskeletal Pain. Disclosure: Dr. Guterman has nothing to disclose.