Are there any studies on the efficacy of Topiramate (Topamax) in treating Burning Mouth Syndrome?

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Last updated: March 19, 2025View editorial policy

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From the Guidelines

There is no evidence to support the use of Topiramate (Topamax) in treating Burning Mouth Syndrome, and instead, gabapentin has been shown to be effective in reducing symptoms of burning in the mouth 1.

Treatment Options for Burning Mouth Syndrome

The management of burning mouth syndrome is complex and often involves a multidisciplinary approach. According to the NCCN guidelines, treatment options for oral dysesthesia, including burning mouth syndrome, include:

  • Gabapentin, which has been evaluated in a randomized, double-blind, placebo-controlled trial and shown to reduce burning sensation in some patients 1
  • High potency topical steroids (gel or dental paste preferred)
  • Viscous lidocaine
  • Dietary modifications
  • Assessing the location and character of pain, ruling out odontogenic or mucosal source, and assessing the severity of pain and impact on function

Important Considerations

It is essential to note that the evidence for treating burning mouth syndrome is limited, and more research is needed to determine the most effective treatment options. Patients should always consult with healthcare providers before starting any medication regimen, as potential side effects and interactions need to be carefully considered. Alternative approaches like avoiding spicy foods, alcohol, and tobacco may also help manage symptoms.

Key Takeaways

  • Gabapentin is a potential treatment option for burning mouth syndrome, with some evidence supporting its effectiveness 1
  • Topiramate is not recommended for treating burning mouth syndrome due to a lack of evidence
  • A multidisciplinary approach, including dietary modifications and topical measures, may be necessary to manage symptoms effectively

From the Research

Efficacy of Topiramate in Treating Burning Mouth Syndrome

  • There are limited studies directly investigating the efficacy of Topiramate (Topamax) in treating Burning Mouth Syndrome.
  • However, a study published in 2007 2 reported a case of a 65-year-old woman with glossodynia, which is characterized by painful sensations in the mouth and throat, and is sometimes associated with Burning Mouth Syndrome.
  • In this case, treatment with topiramate induced a complete improvement of symptoms, suggesting that topiramate could be a useful therapeutic option in the treatment of glossodynia and potentially Burning Mouth Syndrome.
  • Another study published in 2003 3 reviewed the use of topiramate for treating neuropathic pain, which may be related to Burning Mouth Syndrome, and suggested that topiramate may be effective in alleviating neuropathic pain due to its multiple mechanisms of action.
  • A 2013 systematic review 4 found no convincing evidence for the efficacy of topiramate in treating neuropathic pain, but this review focused on diabetic neuropathic pain and may not be directly applicable to Burning Mouth Syndrome.
  • Other studies have investigated the use of gabapentin for treating Burning Mouth Syndrome 5, but the efficacy of topiramate specifically for this condition remains largely unexplored.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Use of topiramate for glossodynia.

Pain medicine (Malden, Mass.), 2007

Research

Topiramate for neuropathic pain and fibromyalgia in adults.

The Cochrane database of systematic reviews, 2013

Research

Effectiveness of gabapentin for treatment of burning mouth syndrome.

Archives of otolaryngology--head & neck surgery, 2004

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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