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.

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Ethambutol (Esanbutol^®) has a pronounced tuberculostatic activity. Side effects are an infrequent. Here we report an oral lichenoid drug eruption on the buccal mucosa and the lip in a 75-year-old Japanese man which appeared 2 weeks after commencement of ethambutol. The all lesions resolved dramatically upon withdrawal of the drug. To our knowledge, this is the first report of a lichenoid drug eruption of oral mucosa induced by ethambutol.

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We encountered a case of oral cancer who developed neuroleptic malignant syndrome due to methylphenidate hydrochloride used to shake off sleepiness for opioid.
A male of his 70s in the mandibular gingival carcinoma visited our hospital. And the tumor was resected. Postoperatively wound pain continued, therefore using morphine for pain control was good. However, since sleepiness did not decrease, the oral administration of methylphenidate hydrochloride was initiated. After administration for 3 days, the CPK level to 4,988 IU/l, the WBC level to 12,750/mm³ increased. Facial redness, perspiration, an increased pulse, general malaise, and decreased appetite were observed. Neuroleptic malignant syndrome was suspected, and the administration of this drug was discontinued. The symptoms improved after 6 days.

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