Disturbances of Taste and Smell Induced by Drugs

Abstract

We reviewed the current literature (1980–1990, 1991–1996) concerning drugs associated with anosmia, hyposmia, dysgeusia, parageusia, and ageusia, and the impact of these adverse effects. Case reports of patients with sudden and delayed onset of one of these disorders with evidence for implication of a drug were included. Disturbances of taste and smell among the elderly and chronically ill, including those with thermal injury, decreases interest in eating and secondarily impairs healing of wounds. Mechanisms involved with these sensory disturbances include deposition of silver sulfate in nerves after use of topical agents containing silver, altered influx of calcium and other ions, chelation or depletion of tissue‐bound zinc, disturbed bradykinin catabolism and second messenger synthesis, catabolism, and altered prostaglandin systems. Other mechanisms, particularly prolonged chemosensory disorders after early drug discontinuation, remain unknown.

Causative factors of taste disorders in the elderly, and therapeutic effects of zinc

“…Taste disorders are symptoms of neurological derangement, and there are various causes. These include systemic diseases, 9 , 13 – 19 drug treatment, 6 , 22 , 23 zinc deficiency, 7 , 8 glossitis and stomatitis, 24 inflammation of the upper respiratory tract, 20 disorders of the central nervous system, 25 and idiopathic factors 7 , 8 …”

Case Report: Diagnosis of hypogeusia after oral exposure to commercial cleaning agent and considerations for clinical taste testing

“…BMS has been associated with two factors detailed in this report: angiotensin converting enzyme (ACE) inhibitors 22 and oral candidiasis 22 . ACE inhibitors inhibit zinc action in the salivary glands and taste receptor cells thereby reducing saliva production and affecting taste 23 . Brown et al .…”

“…The testing results suggest that some degree of deeper tissue injury occurred, sufficient to affect progenitor cells in the base of tongue papillae, and/or to sufficient depth such that permanent neuronal dysfunction resulted. Medical treatment options that could be attempted include discontinuing lisinopril and trialing a different (nonsulfhydryl) ACE inhibitor 23 , or dietary supplementation with selenium methionine 28 . Additional testing and treatment for diseases associated with taste dysfunction (e.g., diabetes, Sjorgren’s syndrome, vitamin deficiencies, and hypothyroidism) can also be performed if signs or symptoms warrant.…”

Taste and Smell Disturbance Resulting From Midodrine

“…Medicines that have been linked to changes in olfactory perception include dihydropyridine calcium channel blockers, beta-blockers, ciprofloxacin, diltiazem, doxycycline, enalapril, lovastatin, methotrexate, and terbinafine, none of which were being used by the patient at the time of symptom onset. 8…”