Burning mouth syndrome

Hi All
I have had Parkinson’s for a few months now and I think the drugs are helping.
I can keep going with it all because it gives me no actual pain. However, I have also developed Burning mouth syndrome that is driving me up the wall !!
I have tried just about every lotion and position for sore mouths that I can find but nothing seems to work for more than an hour or so.

I read the other day that BMS is caused by Anxiety and stress. What does Burning mouth give you? Anxiety and stress !!! So it is all self perpetuating !!
The only thing I can think of that can reduce anxiety and stress is Cannabis or LSD !!

Anyone tried It ???

I’m sorry to hear about your struggles with Parkinson’s and Burning Mouth Syndrome (BMS). It’s understandable how frustrating and challenging it can be to find relief. While some may find cannabis or LSD helpful for reducing anxiety and stress, it’s essential to consult with a healthcare professional before trying any alternative treatments. They can provide guidance tailored to your specific medical condition and help you explore safe and effective options. Additionally, therapy and relaxation techniques may also be beneficial in managing anxiety and stress associated with BMS.

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29/3/24 For any new symptom, first check if any drugs you are taking can cause it. Look up side effects & search for case reports. SOME REFERENCES THAT MIGHT BE USEFUL:

Burning mouth syndrome in Parkinson’s disease: dopamine as cure or cause? Elizabeth A. Coon and Ruple S. Laughlin J Headache Pain. 2012 Apr; 13(3): 255–257.

We report a Parkinson’s disease patient who developed burning mouth syndrome after starting carbidopa/levodopa and had improvement of her symptoms after discontinuation of carbidopa/levodopa and resolution upon initiation of a dopamine agonist.

Valproate-induced burning mouth syndrome in a male with fibromyalgia and bipolar spectrum disorder A. Raia , V. Caruso , C.Montalbano , L.Migli , C.Raia , S.Pini Arch Clin Cases. 2023 Sep 20;10(3):125-127.

Drug-Induced Burning mouth syndrome … has been reported with angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, antiretrovirals, anticoagulants, chemotherapy, and drugs commonly used in the treatment of neuropsychiatric disorders such as antidepressants, benzodiazepines, and antipsychotics.

Regarding anticonvulsants a literature search found a previous case of Topiramate-Induced Burning mouth syndrome but no previous report of valproate-induced Burning mouth syndrome. [IN] Our case …Symptoms resolved completely when the drug was stopped, and the association between symptoms and drug was replicated after drug re-administration.

Burning mouth disorder and Parkinson’s disease: A scoping review of the literature Guru O, Ramesh Balasubramaniam, Gary D. Klasser First published: 28 Feb.2023 Journal of Oral Rehabilitation Vol.50, Issue 6 p. 488-500

The case report by Coon and Laughlin presented an interesting scenario whereby BMD was triggered after the introduction of levodopa, a dopamine precursor

About 96% of patients in the Clifford et al study were on levodopa, 87.5% of PD patients suffering from BMD in Bonenfant et aL study were taking dopamine replacement agents (which included levodopa, pramipexole, ropinirole, rotigotine, piribedil, apomorphine) and all patients in the O’Neil et al study were also medicated with dopamine replacement agents.
O’Neil et al found a statistically significant association between levodopa equivalent dosage and the presence of BMD (with those suffering from BMD on higher average levodopa equivalent dose).

PAINFUL PARKINSON’S DISEASE N.Quinn, A.E.Lang, W.C.Koller, C.D.Marsden The Lancet Vol,327, Issue 8494, 14 June 1986
A number of patients with Parkinson’s disease complain of severe and distressing pain. Many of them are referred for psychiatric or other inappropriate treatment… The key diagnostic clue to the origin of the pain is that in almost all cases it fluctuates in parallel with the motor changes associated with levodopa treatment…. The nature of this temporal association in the individual case, as well as aiding diagnosis, often indicates the need for appropriate modifications in antiparkinsonian therapy, which can be far more effective than conventional analgesic treatments.

Development of a Non-Motor Fluctuation Assessment Instrument for Parkinson Disease Galit Kleiner-Fisman, R. Martine, A.E. Lang ,and M.B. Stern Parkinson’s Disease vol. 2011, ArticleID 292719, 2011.

21.In the last week, did you have painful sensations in your body (e.g., aching, tightness, burning, or sharp, dull or throbbing pain)?
If you answered “yes”, did this get better or worse after you took your levodopa?YesNo?