Drug-induced disturbances of smell and taste

K K Jain MD (Dr. Jain is a consultant in neurology and has no relevant financial relationships to disclose.)
Originally released March 5, 1999; last updated March 2, 2016; expires March 2, 2019

Overview

Although the list of drugs producing disturbances of smell and taste is fairly long, new cases continue to be reported with medications that have not been previously associated with such disturbances. Some of the symptoms resolve on discontinuation of the offending medication, whereas others are persistent and impair quality of life. In this article, the author reviews the pathomechanism, differential diagnosis, and management of drug-induced disturbances of smell and taste. Further, he discusses them according to categories of drugs and provides a simple classification of these disorders.

Key points

 

• A large number of drugs from different pharmacological categories have been associated with disturbances of taste and smell.

 

• These disturbances may occur together or involve only smell or taste.

 

• An understanding of pathomechanism of these disorders is still limited.

 

• Treatment of smell and taste disturbances is mostly limited to zinc supplementation and the dose reduction of the offending drug or the substitution of the offending drug by another in the same therapeutic category.

Historical note and terminology

A large number of drugs affect the taste and smell sensations. Patients may report total loss of taste or, more likely, an alteration of taste sensation with or without disturbance of smell. Dysosmia is a general term used to describe all smell disturbances. A complete loss of smell, termed anosmia, is the inability to detect or recognize vapors at the primary or accessory areas of olfaction. However, a complete loss of smell is rare, and most drug-induced smell disorders involve only a reduced sense of smell, known as hyposmia, of familiar vapors such as those of perfumes. The term “ageusia” is used for loss of taste and hypogeusia for diminished taste.

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