ESRA Academy. Basso Ricci E. Sep 9, 2016; 138299; 0126 Topic: Chronic Pain Management
Erika Basso Ricci
Erika Basso Ricci

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Background and Aims:

The burning mouth and tongue syndrome (BMS) is characterized by persistent burning pain of the oral mucosa, its pathology seems to be related to small fiber neuralgia and restless legs syndrome.


To evaluate the efficacy and safety of combination therapy with pramipexolo and amytriptilline, author performed a retrospective observational study of 25 patients  suffering from persistent, refractory BMTS. Both pramipexol and amytriptilline were titrated, respectively, up to 0.75 mg and 50 mg daily. Initial treatment was given over a one month trial/titration period. No responders (4 patients, 16%) were discontinued after 30 days of treatment. (Figure 1) Responders continued treatment for an average of 21.6 months. (Figure 2) Adverse events were monitored, intensity of pain and grade of satisfactory, using a numeric rating scale (NRS 0-100) were recorded once per week.


The overall mean pain intensity score at baseline was 81.50 (SD 1.7): there was  a considerable variation of pain sensation between patients with BMS and patients with BMS extended to the tongue. On the average, pain intensity decreased to a score of 40.25 (SD 0.5), while grade of satisfaction increased up to 67.7 (SD 0.5) of first week evaluation. 7 patients (33.3%) was completely pain free within 2 months of initial treatments. No adverse effects were recorded.

                                 Figure 1

                           Figure 2


Combination therapy with with pramipexol and amytriptilline seems to have the potential to reduce BMS pain severity and reduce remission in a large portion of suffers.

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