Drug-Induced Changes in Taste or Smell

 

Effects on taste and smell may include:

(1) reduced (hypogeusia) or absent taste (ageusia)

(2) distorted taste (dysgeusia)

(3) reduced (hyposmia) or absent smell (anosmia)

(4) distorted smell (dysosmia)

 

Drugs that may affect taste and/or smell include:

(1) anti-arrhythmic agents

(2) antibiotics

(3) antifungal agents

(4) antihistamines

(5) antihypertensive drugs

(6) anti-inflammatory agents

(7) antipsychotic agents

(8) antiviral agents

(9) anxiolytic agents

(10) bronchodilators

(11) chemotherapeutic agents

(12) CNS stimulants

(13) diuretics

(14) drugs used to treat glaucoma

(15) drugs used to treat hyperthryoidism

(16) drugs used to treat Parkinson's disease

(17) lithium

(18) migraine medications

(19) muscle relaxants

(20) sedatives or hypnotics

(21) smoking cessation agents

(22) smoking cessation aids

(23) statins

(24) topical silver salts

(25) tricyclic antidepressants

(26) zinc

 

Patients at risk:

(1) elderly

(2) polypharmacy

(3) pre-existing impairment of taste and/or smell

(4) excessive drug levels

(5) following burns (smoke inhalation vs thermal injury)

 

Consequences:

(1) poor appetite, malnutrition and/or weight loss

(2) impaired quality of life

(3) decreased appetite and/or enjoyment of food

(4) change in diet with increase in salt or sugar intake

(5) failure to detect hazards such as smoke or gas

 

Diagnosis:

(1) change in taste or smell following start of drug therapy

(2) gradual return to pre-treatment level following discontinuation of drug therapy or a reduction in dose

(3) exclusion of alternative explanations

 

Differential diagnosis:

(1) heavy metals and other toxic exposures

(2) occupational exposures that affect taste and/or smell

(3) head and neck trauma

(4) smoking and/or drinking

(5) concurrent illness