Treatment of Persistent Idiopathic Dentoalveolar Pain with Venlafaxine: A Multicentric Retrospective Study on Its Effectiveness and Safety

Abstract

Purpose

To determine the effectiveness and safety of venlafaxine in treating persistent idiopathic dentoalveolar pain (PIDP).

Patients and Methods

A retrospective analysis was conducted on a cohort comprising 129 patients with a definite diagnosis of PIDP, who were treated with venlafaxine between May 2020 and December 2022 at three different institutions. Baseline characteristics were statistically described, and visual analog scale (VAS) scores before and during treatment were collected. The percentage of pain relief was calculated. Differences in baseline characteristics between responsive and unresponsive patients were evaluated. Additionally, side effects experienced during treatment were also summarized.

Results

Among the included patients, 4 suffered immediate side effects following the initial dose of venlafaxine and the treatment was discontinued. 104 (80.6%) patients achieved pain relief. VAS scores of responsive patients at weeks 2, and months 1, 2, and 3 were significantly lower than baseline (p<0.001). Duration of pain was the only factor related to responsiveness (Wilcoxon rank sum test p<0.001, logistic regression p=0.001). 64 patients (49.6%) suffered from mild side effects. No serious side effects were observed during the study.

Conclusion

Venlafaxine is potentially effective and safe in the management of PIDP. Early application of venlafaxine following the diagnoses of PIDP can result in a higher possibility of pain relief.

Keywords:

• venlafaxine
• persistent idiopathic dentoalveolar pain
• effectiveness
• serotonin-norepinephrine reuptake inhibitors
• pain management

Abbreviations

PIDP, persistent idiopathic dentoalveolar pain; VAS, visual analog score; ICOP, International Classification of Orofacial Pain; AO, atypical odontalgia; TCA, tricyclic antidepressants; SNRI, serotonin-norepinephrine reuptake inhibitors; HDRS, Hamilton depression rating scale.

Acknowledgments

We acknowledge our colleagues who contributed to this work but not met the criteria for authorship. This study was funded by the Capital’s Funds for Health Improvement and Research (2020-2-2046) and Capital Medical University Research and Cultivation Fund (No. PYZ22115).

Disclosure

The authors report no conflicts of interest in this work.