title: [Burning mouth syndrome: pathogenic and therapeutic concepts].
abstract: Burning mouth syndrome (BMS) is a chronic pain condition characterized by pain, burning sensations and dryness within an oral mucosa, without any clinical changes of the latter. It occurs approximately seven times more frequently in women, mostly in perimenopausal age. The psychiatric aspect of BMS is significant: the most frequent co-morbidities are depression and anxiety disorders, and a number of psychotropic drugs play an essential role in its treatment. In the present review, the most important pathogenic and treatment concepts of BMS have been discussed. The BMS may be similar to neuropathic pain and has some related pathogenic elements with fibromyalgia and the restless leg syndrome. In primary BMS, the features of presynaptic dysfunction of dopaminergic neurons and deficiency of endogenous dopamine levels have been demonstrated. Other neurotransmitters such as serotonin, noradrenaline, histamine as well as hormonal and inflammatory factors may also play a role in the pathogenesis of BMS. In the pharmacological treatment of BMS a variety of drugs have been used including benzodiazepines, anticonvulsants, antidepressants and atypical antipsychotic drugs. In the final part of the paper, the possibility of using atypical antipsychotic drug, olanzapine, in the treatment of BMS has been discussed. In the context of the recent studies on this topic, a case of female patient with the BMS lasting more than ten years has been mentioned, in whom the treatment with olanzapine brought about a rapid and significant reduction of symptoms. The probable mechanism of the therapeutic effect of olanzapine in BMS can include its effect on dopaminergic receptors and probably also on histaminergic, noradrenergic and serotonergic ones.
authors.forename: Ewa
authors.initials: E
authors.lastname: Ferensztajn
authors.forename: Dorota
authors.initials: D
authors.lastname: Łojko
authors.forename: Janusz
authors.initials: J
authors.lastname: Rybakowski
mesh_terms: D000367:Age Factors; D000927:Anticonvulsants / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use; D002054:Burning Mouth Syndrome / Q000175:diagnosis* / Q000188:drug therapy / Q000628:therapy*; D005260:Female; D006801:Humans; D028022:Low-Level Light Therapy / Q000379:methods*; D008297:Male; D009424:Nervous System Physiological Phenomena; D017697:Premenopause; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D011788:Quality of Life; D012307:Risk Factors; D014149:Tranquilizing Agents / Q000627:therapeutic use*; D016387:Women's Health
chemical_list: D000927:Anticonvulsants; D000928:Antidepressive Agents; D014150:Antipsychotic Agents; D011619:Psychotropic Drugs; D014149:Tranquilizing Agents