Effectiveness of milnacipran for the treatment of chronic pain in the orofacial region.
OBJECTIVE
The effect of milnacipran for the treatment of chronic pain in the orofacial region, including burning mouth syndrome (BMS) and atypical odontalgia (AO), was assessed while accounting for the influence of concurrent depressive symptoms on the pain-relieving effect.


METHODS
Milnacipran was administered for 12 weeks to 36 patients with chronic pain in the orofacial region (3 men and 29 women, aged between 22 and 76 years with a mean age of 59 years). Of those patients, 22 and 10 patients had BMS and AO, respectively. The initial dose of milnacipran was 15 mg a day, and the dose was raised up to 100 mg a day. Pain was assessed using the visual analog scale, and symptoms of depression were evaluated using the Hamilton Depression Rating Scale at baseline and at weeks 1, 2, 4, 6, 8, 10, and 12 of the study treatment.


RESULTS
Data from 32 patients who completed the study were included in the analysis. The visual analog scale score significantly decreased after the 12-week treatment, and it showed a similar time course of decline irrespective of concurrent depressive symptoms during the 12 weeks.


CONCLUSIONS
Treatment with milnacipran resulted in a significant improvement of chronic pain in the orofacial region irrespective of concurrent symptoms of depression. The present results suggested that milnacipran may be an effective agent for treatment of such disorders.
Ito
Mikiko
M
Department of Oral and Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University, Nagoya, Aichi, Japan. mi_ito1013@yahoo.co.jp
Kimura
Hiroyuki
H
Yoshida
Keizo
K
Kimura
Yuki
Y
Ozaki
Norio
N
Kurita
Kenichi
K
D018759:Adrenergic Uptake Inhibitors / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D002054:Burning Mouth Syndrome / Q000150:complications / Q000188:drug therapy*; D002908:Chronic Disease; D003521:Cyclopropanes / Q000627:therapeutic use*; D003863:Depression / Q000150:complications / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D005157:Facial Pain / Q000150:complications / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000078764:Milnacipran; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D014098:Toothache / Q000150:complications / Q000188:drug therapy*
D018759:Adrenergic Uptake Inhibitors; D003521:Cyclopropanes; D000078764:Milnacipran; D017367:Selective Serotonin Reuptake Inhibitors