title: Burning mouth syndrome responsive to duloxetine: a case report.
abstract: BACKGROUND
  Burning mouth syndrome (BMS) is a chronic, idiopathic, intraoral mucosal pain condition in the absence of specific oral lesions and systemic disease. Among evidence-based pharmacological treatments for this disorder, topical and systemic clonazepam, levosulpiride, selective serotonin reuptake inhibitors have been used with partial results.
  
  
  METHODS
  We report a case of a 65-year-old otherwise healthy woman with a 3-year history of oral burning. Clinical and laboratory evaluations allowed us to make a diagnosis of burning mouth syndrome. She was treated with duloxetine (60 mg p.o. qd), a selective serotonin, and norepinephrine reuptake inhibitor, obtaining a complete remission of symptoms, evaluated via standardized clinical rating scales, and an improvement of her quality of life and level of functioning.
  
  
  CONCLUSIONS
  The pathogenesis of BMS still remains unclear. Recently, it has been suggested an underlying neuropathic mechanism, demonstrating a dysfunction in the trigeminal nociceptive pathways at peripheral and/or central nervous system level. The rationale behind the administration of duloxetine resides in its central mechanism of action, and analgesic effects previously demonstrated in diabetic peripheral neuropathy, and fibromyalgia. Also, it has been shown to reduce painful physical symptoms associated with depression.
  
  
  CONCLUSIONS
  We hypothesize that duloxetine might represent a useful, effective, and additional therapeutic option in the treatment of BMS.
authors.affiliation: Oral Medicine Unit, Department of Odontostomatological and Maxillofacial Sciences, Federico II University of Naples, Naples, Italy. mignogna@unina.it
authors.forename: Michele D
authors.initials: MD
authors.lastname: Mignogna
authors.forename: Daniela
authors.initials: D
authors.lastname: Adamo
authors.forename: Vittorio
authors.initials: V
authors.lastname: Schiavone
authors.forename: Marco Giuseppe
authors.initials: MG
authors.lastname: Ravel
authors.forename: Giulio
authors.initials: G
authors.lastname: Fortuna
mesh_terms: D000368:Aged; D002054:Burning Mouth Syndrome / Q000188:drug therapy* / Q000503:physiopathology; D000068736:Duloxetine Hydrochloride; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D013876:Thiophenes / Q000627:therapeutic use*
chemical_list: D000068736:Duloxetine Hydrochloride; D017367:Selective Serotonin Reuptake Inhibitors; D013876:Thiophenes