Outcome predictors affecting the efficacy of clonazepam therapy for the management of burning mouth syndrome (BMS)

BMS is a common condition characterized by chronic oral mucosal pain condition and primarily affects elderly women. Although clonazepam therapy has been widely used due to its efficacy, it is not always effective because of the complexity of BMS pathogenesis. In this study, we have investigated outcome predictors of clonazepam therapy in patients with BMS. One hundred patients with BMS (7 men and 93 women, mean age 58.5 ± 10.8 years) were instructed to take 0.5 mg of clonazepam once or twice daily for 4 weeks. The patients were sub-grouped according to psychological status, salivary flow rate, presence of psychiatric medications, symptom area and duration, symptom severity, presence of oral parafunctions, and accompanying oral complaints. The changes in symptoms were analyzed and compared between the sub-groups. Subjects with T-scores ≤50 for each psychological symptom dimension, a greater degree of initial symptoms (visual analog scale (VAS) ≥ 5), and accompanying oral complaints, such as xerostomia and taste disturbance, displayed greater decreases in symptoms compared with their counterparts. In conclusion, psychological status, initial symptom severity, and the presence of xerostomia and/or taste disturbance can serve as outcome predictors of clonazepam therapy for patients with BMS.