Two cases of recovery from glossodynia in elderly patients with the use of sertraline

Background: It can be difficult to treat glossodynia in the elderly due to various restrictions on the use of pharmaceutical therapy. We report two cases in which elderly patients with glossodynia recovered with the use of sertraline, which in July 2006 became the third SSRI approved for use in Japan.<BR>Case 1: Female, 81 years old.<BR>Chief complaint: Burning glossal pain.<BR>Medical history: Ischemic cardiac disease, hyperpiesia. History of present disease: She had suffered burning glossal pain persistently for approximately 20 years. She had visited various medical facilities prior to referral to our clinic but the pain had not been alleviated. Milnacipran did reduce the pain by approximately 70% but this had to be stopped due to constipation and drug eruption. Sertraline (25mg/day) was then prescribed, and the pain disappeared immediately.<BR>Case 2: Female, 88 years old.<BR>Chief complaint: Prolonged burning glossal pain.<BR>Medical history: Cerebral infarction, colorectal carcinoma.<BR>History of present disease: A tingling proglossal pain had been persisting for several months. No anemia or minor element deficiency was detected in the medical examination, and steroid ointment and vitamin preparation were ineffectual. She visited our clinic for fear of oral cancer. The pain was almost entirely relieved by the use of sertraline (12.5mg/day).<BR>Discussion & Conclusion:<BR>The treatment of glossodynia in the elderly can be complicated by coexisting diseases. The sideeffects of anti-depressants often also appear due to their lowered immune systems. In addition, antidepressants are reported to be ineffective for elderly patients with organic cerebral lesions. We did find, however, that sertraline was effective and produced no particular side effects even under the conditions of these two cases. It is suggested that sertraline may be an effective treatment for glossodynia in the elderly.