Original Article Elmer ress J Clin Med Res • page no. to be assigned Treatment of Burning Mouth Syndrome With Amisulpride Carmen Rodriguez-Cerdeiraa, c, Elena Sanchez-Blancob Abstract Background: Burning mouth syndrome (BMS) is a frequently occurring disease characterized by a burning or painful sensation in the tongue and/or other oral sites without clinical mucosal ab- normalities or lesions. Its etiopathology is unknown, although lo- cal, systemic, and psychological factors have been associated with BMS. The syndrome is multifactorial, and its management remains unsatisfactory. The purpose of this study was to obtain preliminary data regarding the efficacy and tolerability of amisulpride in BMS treatment. Methods: The subjects were treated with amisulpride (50 mg/day) for 24 weeks. Efficacy assessment included a visual analogue scale (VAS) for pain intensity, the Hamilton Rating Scale for Depression (HAM-D), the Hamilton Rating Scale for Anxiety (HASM-A), and the Clinical Global Impression Scale-Efficacy Index (CGI-EI). Results: The treatment regimens resulted in a significant improve- ment in burning mouth symptoms from baseline at week 24, as in- dicated by the quantitative mean illness duration VAS score, HAM- D, and HAM-A. Amisulpride appears to be effective and patients show a rapid response to treatment. No serious adverse effects were Manuscript accepted for publication April 30, 2012 aDermatology Department, CHUVI and University of Vigo, Vigo, Spain bUniversity of Vigo, Vigo, Spain cCorresponding author: Carmen Rodriguez-Cerdeira. Email: aristoteles_cerdeira@yahoo.es doi:10.4021/jocmr972w encountered in these patients. Conclusions: Amisulpride is effective and well tolerated as a short- term treatment. It is particularly efficacious at the start of treatment and has shorter response latency. Double-blind placebo-controlled trials are needed for further assessment of the efficacy of amisul- pride in BMS treatment. Keywords: Burning mouth syndrome; Amisulpride; Women Introduction Primary burning mouth syndrome (BMS) is a chronic, id- iopathic intraoral mucosal pain condition that is not accom- panied by clinical lesions or systemic disease. Whether this condition should be referred to as a disease, disorder, or syndrome is uncertain, but data to justify any change in tax- onomy are insufficient at present. BMS is often accompanied by xerostomia and taste disturbances. A neuropathological basis for BMS has recently been proposed, suggesting that it could be regarded as an oral dysesthesia or painful neuropa- thy. However, our incomplete understanding of the epidemi- ology, etiology, and pathophysiology of BMS, and the lack of any diagnostic criteria, are barriers to critical investigation and the selection of effective treatments [1]. There is only limited evidence to guide clinicians in the management of patients with BMS. The estimated prevalence of BMS re- ported in recent studies ranges between 0.7% and 4.6% of the general population; most cases occur in postmenopausal women. The rate of occurrence of this disorder in women is 20% higher than that in men [2]. The most prevalent co- morbidity is a major depressive episode. No other psychiat- ric disorders have been associated with BMS in comparison with healthy people [3, 4]. Amisulpride is a selective dopamine antagonist. It has a high affinity for D (Ki = 2.8 nM) and D (Ki = 3.2 nM) 2 3 dopaminergic receptors. Dosage ranges from 200 to 1200 mg/day. Lower doses (less than 50 mg) preferentially block D autoreceptors, which control the synthesis and release of 2 dopamine. This results in an increase in dopaminergic trans- Articles © The authors | Journal compilation © J Clin Med Res and Elmer Press™ | www.jocmr.org This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited