Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Dec 30:15:3599-3607.
doi: 10.2147/NDT.S235669. eCollection 2019.

Therapeutic Dose of Amitriptyline for Older Patients with Burning Mouth Syndrome

Takayuki Suga  1 , Miho Takenoshita  1 , Takeshi Watanabe  1 , Trang Th Tu  1 , Lou Mikuzuki  1 , Chaoli Hong  1 , Kazuhito Miura  2 , Tatsuya Yoshikawa  1 , Takahiko Nagamine  3 , Akira Toyofuku  1
Affiliations

Therapeutic Dose of Amitriptyline for Older Patients with Burning Mouth Syndrome

Takayuki Suga et al. Neuropsychiatr Dis Treat. .

Abstract

Objective: To assess the therapeutic dose and safety of amitriptyline and the outcome following treatment with amitriptyline among older patients with burning mouth syndrome (BMS).

Methods: 187 consecutive patients were prescribed amitriptyline as a first-line medication from April 2016 to September 2018 and followed-up for >1 month. Patients were divided into 3 groups: group 1, 113 patients aged <65 years; group 2, 52 patients aged between 65 and 74 years; and group 3, 22 patients aged 75 years or older. The visual analog scale (VAS), Pain Catastrophizing Scale (PCS), Somatic Symptom Scale-8 (SSS-8), Patient Global Impression of Change (PGIC), and Short-form McGill Pain Questionnaire (SF-MPQ) were used for analysis.

Results: Thirty-two patients (17 in group 1, 10 in group 2, and 5 in group 3) stopped taking amitriptyline due to side effects. There were no differences among the groups with respect to sex; scores of VAS, PCS, and SSS-8; and drop-out ratio. There were no significant differences in the VAS, PCS, and PGIC scores among the groups after 1 month. The mean daily dose after 1 month was 20.4 ± 8.6 mg in group 1, 17.3 ± 8.7 mg in group 2, and 13.2 ± 5.8 mg in group 3; this difference was significant (p value = 0.003). About 76% of patients showed improvements in their symptoms (PGIC ≥ 3). About 90% of patients reported side effects. No serious side effects occurred.

Conclusion: The therapeutic dose of amitriptyline may be lower for older BMS patients than for younger patients.

Keywords: aged; amitriptyline; burning mouth syndrome; chronic pain.

PubMed Disclaimer

Conflict of interest statement

This work was supported in part by the JSPS KAKENHI (Grant Number 19K10328) awarded to Dr. Toyofuku. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Flow chart of the study design.
See this image and copyright information in PMC

References

    1. Urquhart DM, Wluka AE, van Tulder M, et al. Efficacy of Low-dose amitriptyline for chronic low back pain: a randomized clinical trial. JAMA Intern Med. 2018;178(11):1474–1481. doi:10.1001/jamainternmed.2018.4222 - DOI - PMC - PubMed
    1. Jaaskelainen SK, Woda A. Burning mouth syndrome. Cephalalgia. 2017;37(7):627–647. doi:10.1177/0333102417694883 - DOI - PubMed
    1. Suga T, Watanabe T, Aota Y, Nagamine T, Toyofuku A. Burning mouth syndrome: the challenge of an aging population. Geriatr Gerontol Int. 2018;18(12):1649–1650. doi:10.1111/ggi.2018.18.issue-12 - DOI - PubMed
    1. Hens MJ, Alonso-Ferreira V, Villaverde-Hueso A, Abaitua I, Posada de la Paz M. Cost-effectiveness analysis of burning mouth syndrome therapy. Community Dent Oral Epidemiol. 2012;40(2):185–192. doi:10.1111/j.1600-0528.2011.00645.x - DOI - PubMed
    1. Breckons M, Shen J, Bunga J, Vale L, Durham J. DEEP study: indirect and out-of-pocket costs of persistent orofacial pain. J Dent Res. 2018;97:22034518773310. - PubMed