Bourning mouth syndrome: pathogenic and therapeutic concepts.
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Uniwersytet Medyczny w Poznaniu
Uniwersytet Medyczny
Ewa Ferensztajn   

Uniwersytet Medyczny w Poznaniu, ul. Szpitalna 27/33, Poznań, 60-572 Poznań, Polska
Submission date: 2013-04-04
Final revision date: 2013-09-20
Acceptance date: 2013-09-21
Publication date: 2013-12-16
Psychiatr Pol 2013;47(6):973–988
Bourning mouth syndrome (BMS) is a chronic pain condition characterized by pain, burning sensations and dryness within an oral mucosa, without any clinical changes of the latter.It occurs approximately seven times more frequently in women, mostly in perimenopausal age.Psychiatric aspect of BMS is significant: the most frequent co-morbidities are depression and anxiety disorders and a number of psychotropic drugs play an essential role in its treatment.In the present review, the most important pathogenic and treatment concepts of BMS have been discussed.The BMS may be similar to neuropathic pain and has some related pathogenic elements with fibromyalgia and the restless leg syndrome.In primary BMS, the features of presynaptic dysfunction of dopaminergic neurons and deficiency of endogenous dopamine levels have been demonstrated.Other neurotransmitters such as serotonin, noradrenaline, histamine as well as hormonal and inflammatory factors may also play a role in the pathogenesis of BMS.In the pharmacological treatment of BMS a variety of drugs has been used including benzodiazepines, anticonvulsants, antidepressants and atypical antipsychotic drugs.In the final part of the paper, a possibility of using atypical antipsychotic drug, olanzapine, in the treatment of BMS has been discussed.In the context of the recent studies on this topic, a case of female patient with the BMS lasting more than ten years has been mentioned in whom treatment with olanzapine brought about rapid and significant reduction of symptoms.The probable mechanism of the therapeutic effect of olanzapine in BMS can include its effect on dopaminergic receptors and probably also on histaminergic, noradrenergic and serotonergic ones.