Amitriptyline effectiveness in burning mouth syndrome: An in‐depth case series analysis

Author:

Gonçalves Douglas Rodrigues12,Botelho Leonardo Monteiro3,Carrard Vinícius Coelho12,Martins Marco Antônio Trevizani2,Visioli Fernanda14ORCID

Affiliation:

1. Department of Oral Pathology, School of Dentistry Universidade Federal do Rio Grande do Sul Porto Alegre Rio Grande do Sul Brazil

2. Oral Medicine Unit, Otorhinolaryngology Service Hospital de Clínicas de Porto Alegre Porto Alegre Rio Grande do Sul Brazil

3. Pain Management and Palliative Medicine Service Hospital de Clínicas de Porto Alegre Porto Alegre Rio Grande do Sul Brazil

4. Experimental Research Center Hospital de Clínicas de Porto Alegre Porto Alegre Rio Grande do Sul Brazil

Abstract

ObjectivesTo assess the effectiveness of amitriptyline (AMT), and to identify the determinants of the treatment's effectiveness in patients diagnosed with burning mouth syndrome (BMS).BackgroundTreatment of BMS is challenging and no established treatment protocol is available. AMT may be an important treatment option, cout not all patients benefit from this drug. Studies assessing factors related to treatment response are valuable in improving decision‐making.Materials and MethodsThis case series study examined the medical records of all patients diagnosed with BMS at an oral medicine unit in a university hospital from 2008 to 2022. The patients were divided into responders to AMT and non‐responders to AMT. Data on demographic information, comorbidities, medications, types of symptoms and oral subsites affected were collected. Descriptive and bivariate analyses were conducted to assess the association between the independent variables and the outcome, using the Chi‐squared test (P < .05).ResultsThree hundred and fourty‐nine patients reported a burning mouth sensation, 50 of them (14.3%) being diagnosed with primary BMS. Of these, 35 were treated with AMT, and 26 (74.2%) responded significantly to AMT. All males responded to AMT, whereas only 67.9% of females responded. The mean dose of AMT among responders was 29.8 ± 12.3 mg, with most patients achieving a response with 25 mg (61.5% of patients), followed by 50 mg (23%). The concomitant use of an anticonvulsant resulted in non‐response.ConclusionsAMT may be effective in BMS management for most patients.

Funder

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Publisher

Wiley

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