Steven M. Bromley

Drug-Induced Taste Disorders

Numerous drugs have the potential to adversely influence a patient’s sense of taste, either by decreasing function or producing perceptual distortions or phantom tastes. In some cases, such adverse effects are long lasting and cannot be quickly reversed by drug cessation. In a number of cases, taste-related adverse effects significantly alter the patient’s quality of life, dietary choices, emotional state and compliance with medication regimens. In this review, we describe common drug-related taste disturbances and review the major classes of medications associated with them, including antihypertensives, antimicrobials and anti-depressants. We point out that there is a dearth of scientific information related to this problem, limiting our understanding of the true nature, incidence and prevalence of drug-related chemosensory disturbances. The limited data available suggest that large differences exist among individuals in terms of their susceptibility to taste-related adverse effects, and that sex, age, body mass and genetic variations in taste sensitivity are likely involved. Aside from altering drug usage, management strategies for patients with taste-related adverse effects are sorely needed. Unfortunately, stopping a medication is not always an easy option, particularly when one is dealing with life-threatening conditions such as seizures, cancer, infection, diabetes mellitus and uncontrolled hypertension. Hopefully, the information contained in this review will sensitize physicians, researchers and drug manufacturers to this problem and will result in much more research on this pressing topic.

Disorders of Taste and Smell

Disorders of taste and smell not only are uncomfortable to the person involved, e.g. because of an impaired hedonic and sensory experience of food or the continuous presence of a nasty taste, but can also result in loss of body weight and may have a negative influence on the quality of life. In this article both the physiology of chemosensory function and dysfunction of taste and smell are discussed as well as some clinical consequences and their treatment.

Anosmia, Ageusia, and Other Disorders of Chemosensation

Publisher Summary This chapter presents a study on anosmia, ageusia, and other disorders of chemosensation. The chapter provides the nomenclature used to characterize disorders of tasting and smelling, examines a number of commonly encountered chemosensory pathologies, and describe up-to-date means for quantitatively assessing, managing, and treating taste and smell disorders. Disorders of the chemical senses are varied, ranging from phantom sensations that appear in the absence of any obvious stimuli to altered or reduced sensations in response to modality-appropriate stimuli. Anosmia reflects the inability to perceive odors, whereas ageusia reflects the inability to perceive tastants. Such losses can be for all modality-specific stimuli or for just some such stimuli. Lessened function for odorants or tastants are termed hyposmia or hypogeusia respectively, and can be further subdivided, on the basis of quantitative testing, into mild, moderate, and severe categories. Hypergeusia or hyperosmia reflects abnormally heighted taste or smell sensations, whereas taste or smell agnosia reflects the inability to recognize a taste or smell sensation even though sensory processing, language, and general intellectual functions are essentially intact, as in some stroke patients. Distorted smell sensationsare termed dysosmias or parosmias, whereas distorted taste sensations are termed dysgeusias or parageusias. Proper oral hygiene and routine dental care are of paramount importance for proper chemosensory function. The chapter discusses natural course of olfactory disorders, natural course of taste disorders, principles of therapy, and others.