Get access

Burning Mouth Syndrome Responsive to Duloxetine: A Case Report


  • Funding Sources, Financial Relationship and Conflict of Interest: No funding sources for this work were provided. Authors have no conflict of interest or financial relationship to declare and all participated in the preparation of the manuscript.

Michele D. Mignogna, MD, DMD, Head, Oral Medicine Unit, Department of Odontostomatological and Maxillofacial Sciences, “Federico II” University of Naples, Via Pansini 5, 80131 Naples, Italy. Tel: +39817462498; Fax: +39817462197; E-mail:


Introduction.  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 serotonine reuptake inhibitors have been used with partial results.

Case.  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 PO qd), a selective serotonine, 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.

Discussion.  The pathogenesis of BMS still remains unclear. Recently, it has been suggested an underlying neurophatic 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 neurophathy, and fibromyalgia. Also, it has been shown to reduce painful physical symptoms associated with depression.

Conclusion.  We hypothesize that duloxetine might represent a useful, effective, and additional therapeutic option in the treatment of BMS.