精神科医との密な医療連携が奏功した舌痛症の1例

The efficacy of antidepressants for burning mouth syndrome is widely known. However, we often struggle with the choice of treatment for patients with psychiatric comorbidities because of their mental conditions and medications. Here we report a case of burning mouth syndrome with depression successfully treated in close collaboration with a psychiatrist. The patient was a 52-year-old female dental health worker who suffered from chronic burning pain on the right side of her tongue and was referred to our department. On a diagnosis of burning mouth syndrome, we initiated collaboration with her psychiatrist, with regular consultations approximately every three months. The treatment started with 10mg/day of amitriptyline, carefully monitored and adjusted from 25mg to 30mg/day. It was noteworthy that her pain remained in remission without serious fluctuation of psychiatric symptoms. In addition, regular oral examinations and reassurance for cancer phobia seemed to be useful for this favorable clinical outcome. Fortunately, the present case showed a good clinical course, although the situations and conditions vary widely from case to case. If additional medication is deemed necessary for burning mouth syndrome patients with psychiatric disorders, careful collaboration with the attending psychiatrist is crucial.