Gabapentin in the Treatment of Glossodynia

Abstract

Introduction: Glossodynia (burning mouth syndrome, stomatopyrosis, orodynia) is mostly considered to be a psychosomatic disorder characterised by painful sensations within the oral cavity, particularly the tongue, without detectable abnormalities of the mucous membranes or underlying medical disorder. Frequently, patients also complain of xerostomia and dysgeusia. Based on the similar characteristics of glossodynia and neuropathic pain, comparable therapeutic approaches are recommended. Antidepressants have been the therapy of choice to date. These often lead to dry mouth and aggravation of symptoms due to their anticholinergic side-effect profile, and thus to patient incompliance. Gabapentin has been used in the treatment of neuropathic pain for some time now. Side effects and interactions are low. In particular, there are no anticholinergic mechanisms of side effects. Patients and Methods: We treated 4 female glossodynia patients with gabapentin. Results: The intensity of the typical glossodynia symptoms before start of therapy was 4.9 ± 1.1 on the Visual Analog Scale (VAS). Gabapentin therapy (900–2,400 mg/d) decreased the intensity of glossodynia symptoms in all patients to 1.3 ± 0.2. The time to the maximum and stable gabapentin effect ranged from 7 to 21 days. Discussion: Our results show a good gabapentin effect in all treated patients with glossodynia. Gabapentin is thus a very promising therapeutic approach in the treatment of glossodynia. Thanks to the rapid onset of action with only mild side effects and minimal interactions, gabapentin is probably superior to the antidepressants favoured thus far in therapy.

The role of gabapentin in treating diseases with cutaneous manifestations and pain

“…This work has been borne out in other studies 27 . Glossodynia, a psychosomatic disorder with painful sensations in the mouth and throat, especially of the tongue, which have no definable cause, also responds to gabapentin 28 . Gabapentin is useful in treating “hot flashes” and hypothermia, and thus temperature‐sensitive dermatoses 29 …”

Update on pharmacotherapy in psychodermatological disorders

“…A study involving 17 women with vulvodynia reported 82% response rate to gabapentin[ 69 ] a case series of 4 patients with glossodynia responded well to gabapentin[ 70 ] and another study on recalcitrant prurigo nodularis also reports good efficacy. [ 71 ]…”

Psychodermatology Has Grown out of Its Infancy

“…Another endocrinological viewpoint is shown by Harth et al [2004] who have demonstrated possible influences of endocrine stress parameters on male fertility. Meiss et al [2004] have yielded positive results in the treatment of glossodynia when giving gabapentin to the affected patients. We hope you will also enjoy this issue's education section which addresses delusional parasitosis.…”