Dysesthetic ("essential") vulvodynia. Treatment with amitriptyline.
Twenty patients with chronic vulvar burning (vulvodynia) who had relief of symptoms only after treatment with low-dose amitriptyline were studied retrospectively. These patients had several factors in common, which suggested a possible neurologic component to their symptoms. The dosage of amitriptyline (initiated at 10 mg, gradually increased to 40-60 mg daily) was not sufficient to treat depression, but was in the range effective for other cutaneous dysesthesias. This study defines dysesthetic ("essential") vulvodynia, and describes a typical profile and symptom pattern for patients most likely to respond to treatment with amitriptyline (an average age of 66 with vulvodynia for three years). Dysesthetic vulvodynia appears to be a subset different from vulvar vestibulitis and other types of vulvodynia that are less responsive to treatment with tricyclic antidepressants.
McKay
M
M
Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia 30322.
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000639:Amitriptyline / Q000627:therapeutic use*; D015914:Estrogen Replacement Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008012:Lidocaine / Q000627:therapeutic use; D008593:Menopause; D008875:Middle Aged; D010292:Paresthesia / Q000175:diagnosis / Q000188:drug therapy; D012189:Retrospective Studies; D014845:Vulvar Diseases / Q000175:diagnosis / Q000188:drug therapy*
D000639:Amitriptyline; D008012:Lidocaine