piperidines and Burning-Mouth-Syndrome

Burning mouth syndrome (BMS) refers to chronic orofacial pain, unaccompanied by mucosal lesions or other evident clinical signs. It is observed principally in middle-aged patients and postmenopausal women. BMS is characterized by an intense burning or stinging sensation, typically on the tongue or in other areas of the oral mucosa. It can be accompanied by other sensory disorders such as dry mouth or taste alterations. Probably of multifactorial origin, and often idiopathic, with a still unknown etiopathogenesis in which local, systemic and psychological factors are implicated. Currently there is no consensus on the diagnosis and classification of BMS. This study reviews the literature on this syndrome, with special reference to the etiological factors that may be involved and the clinical aspects they present. The diagnostic criteria that should be followed and the therapeutic management are discussed with reference to the most recent studies.

Topics: Acetamides; Amines; Anti-Anxiety Agents; Antidepressive Agents; Antioxidants; Burning Mouth Syndrome; Chlordiazepoxide; Clonazepam; Cognitive Behavioral Therapy; Cyclohexanecarboxylic Acids; Female; Gabapentin; gamma-Aminobutyric Acid; Histamine H2 Antagonists; Humans; Male; Paresthesia; Peripheral Nervous System Diseases; Phantom Limb; Piperidines; Prognosis; Pyridines; Sex Factors; Thioctic Acid; Tongue; Xerostomia

Lafutidine is a unique histamine H(2)-receptor antagonist (H2RA) that has a sensitizing effect on capsaicin-sensitive afferent neurons (CSAN). This effect may make lafutidine useful for the treatment of burning mouth syndrome (BMS).. To evaluate the efficacy and safety of lafutidine in patients with oral burning sensation, a randomized controlled trial was performed. Patients who had been receiving other H2RAs with no sensitizing effect on CSAN were randomly assigned to receive lafutidine 10 mg twice daily for 12 weeks, instead of the previous H2RAs, plus gargling with azulene sulfonate sodium (ASS) (lafutidine group, n = 36) or to continue to receive the previous H2RAs plus ASS gargling (control group, n = 35). The intensity of burning sensation was scored by means of a visual analog scale (VAS).. Thirty-four patients in the lafutidine group and 30 in the control group completed the study. In the lafutidine group, the rate of improvement in the VAS score as compared with the baseline value was significant after 4, 8, and 12 weeks of treatment (P < 0.05). The improvement rate was consistently higher in the lafutidine group than in the control group; the differences between the groups were significant (P < 0.05) after 4, 8, and 12 weeks of treatment. Only two mild abdominal adverse events occurred in the lafutidine group, but neither required the termination of treatment.. Oral lafutidine is very safe and effective for reducing the intensity of oral burning sensation and may therefore be a viable option for the treatment of BMS.

Topics: Acetamides; Aged; Burning Mouth Syndrome; Capsaicin; Female; Histamine H2 Antagonists; Humans; Male; Neurons, Afferent; Pain Measurement; Palliative Care; Piperidines; Pyridines; Sensory System Agents; Treatment Outcome

Topics: Analgesics; Burning Mouth Syndrome; Europe; Facial Pain; Humans; Inflammation; Pain; Peripheral Nerve Injuries; Piperidines; Pyridines; Temporomandibular Joint Disorders; Trust