Topical clonazepam in stomatodynia: a randomised placebo-controlled study

Pain. 2004 Mar;108(1-2):51-7. doi: 10.1016/j.pain.2003.12.002.


Stomatodynia is characterised by a spontaneous burning pain in the oral mucosa without known cause or recognised treatment. The purpose of this double-blind, randomised, multicentre parallel group study was to evaluate the efficacy of the topical use of clonazepam. Forty-eight patients (4 men and 44 women, aged 65+/-2.1 years) were included, of whom 41 completed the study. The patients were instructed to suck a tablet of 1 mg of either clonazepam or placebo and hold their saliva near the pain sites in the mouth without swallowing for 3 min and then to spit. This protocol was repeated three times a day for 14 days. The intensity was evaluated by a 11-point numerical scale before the first administration and then after 14 days. Two weeks after the beginning of treatment, the decrease in pain scores was 2.4+/-0.6 and 0.6+/-0.4 in the clonazepam and placebo group, respectively (P = 0.014). Similar effects were obtained in an intent-to-treat analysis (P = 0.027). The blood concentration of clonazepam was similar whether it was measured 14 days after sucking a tablet three times a day or during the 5 h that followed sucking a single tablet (n = 5). It is hypothesised that clonazepam acts locally to disrupt the mechanism(s) underlying stomatodynia.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Topical
  • Aged
  • Anticonvulsants / administration & dosage*
  • Anticonvulsants / blood
  • Burning Mouth Syndrome / drug therapy*
  • Clonazepam / administration & dosage*
  • Clonazepam / blood
  • Double-Blind Method
  • Facial Pain / drug therapy*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Placebos
  • Treatment Outcome


  • Anticonvulsants
  • Placebos
  • Clonazepam