Involvement of burning mouth syndrome and depression in xerostomia studied by the effects of sulpiride

Abstract

Purpose: The purpose of this study was to investigate the effects of sulpiride, an antidepressant, on xerostomia.
Method: Fifty-five patients who visited the Dry Mouth Clinic, Tsurumi Dental Hospital with subjective oral dryness were enrolled in this study. The cause of the xerostomia in the patients was unknown. The patients did not meet Sjögren's syndrome criteria, and their condition was not congruent with xerostomia caused by radiation therapy to the head and neck, HIV infection, chronic graft-vs-host disease, or diabetes mellitus. The patients were divided into two groups: the dry group, with the chief complaint of dry mouth, and the pain group, with the chief complaint of pain. The patients received oral administration of sulpiride, and the clinical efficacy was evaluated by doctors' subjective judgment and by visual analogue scale (VAS).
Results: Sulpiride was effective in both groups, but the response rate was higher in the pain group than in the dry group according to the doctors' subjective judgment. In the evaluation by VAS, improvements were not obtained in other items such as thirstiness and dysgeusia, although a significant decrease of VAS value was found in "dry mouth" in the dry group. In contrast, in the pain group, significant improvements were found in all items as well as pain.
Conclusions: The results suggested that the dry and pain groups possessed completely different pathophysiologies. The results also suggested that subjective dry mouth may be a partial symptom of burning mouth syndrome (BMS), and that depression was one of the causative factors of xerostomia.