ANOTHER CASE OF ANOSMIA, HYPEROSMIA, CACOSMIA, AGEUSIA AND DYSGEUSIA IN A 41-YEARS OLD WOMAN AT THE FIRST CONSULTATION, AND TREATED BY ANTIDEPRESSANT AND ANTISTRESS DRUGS.

Renato Cocchi, a neurologist and a medical psychlogist.

 

(Other 11 cases histories described)

Summary.

This is the clinical history of a 41-years old patient who had lost taste and sense of smell since four months, following an antibiotic therapy. There were also detected depressive and stress symptoms.

The prescribed therapy - mainly using antidepressant and antistress drugs -, first did not get any results on the taste and on the sense of smell. So, while it started at once to improving depression and stress reactions.

Thirteen months later, the patient thought to have recovered the taste at 99% and the sense of smell at 90%.

Key words: Anosmia, ageusia, hyperosmia, cacosmia, woman, stress, depression, antibiotics, recover, antidepressant, antistress, drug therapy.

 

Italian translation

Anosmia

Drug modulation of stress reactions

Stress symptoms

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At the beginning of 2005, a woman of 41 years came to consultation, and she was suffering from troubles of the sense of smell and of the taste. She contacted me following internet searches. Being a patient with a brief clinical history and a fair positive result in about few more than a year, I wanted to report it, because it had a course that seemed me unusual.

 

The case history.

She was a woman of 41 years to the time of the first consultation, married, with a young adult son, still with her menses elicited by a hormonal bandaid, and she lives in of central town.

Ten second ten days of the January 2005, the first examination.

Troubles of the sense of smell and of the taste: She says of having troubles of the sense of smell (anosmia) since four months, appeared during an antibiotic therapy. In past, she was particularly sensitive to the odours (a hyperosmic person). Initially she has a hyposmic state, and she did not have and not currently has any cacosmia. She became aware that in the same time she started to feel less the tastes (hypogeusia), so arriving to an unpleasant alteration of them (dysgeusia), till their loss (ageusia).

Stress symptoms: She suffers from the cold, inclines to eat sweet things, in particular the chocolate. In the morning, she has the habit to have breakfast late. When she awakes, she has the feeling to have still food in her stomach. Usually she is constipated. She sleeps badly and wakes about 6.00 AM. Nocturia occurs 1-2 times every night, and she does difficulty to resume her sleep. She doesn't talk during her sleep, does not have bad dreams. Rarely she has drooling during her sleep. Nighttime muscular cramps do not occur. At the morning, she wakes up tired, as if she had worked all the night, and she feels a little confused. Intrusive thinking is usual in her. She starts to count objects for no reason. Sudden asthenias happen to her. During the menstruations she has tension headache, and frontal ache with prevalence to the left side. When in stress conditions, she has mediastinal oppression, with a frequent lump in her throat. Some time she has air hunger. The noise and people confusion bother her.

Depression: She cries easily. To the test "Which is the opposite of the colour Red?", she answers: Black. She eats with like milk and diary. About 10.30-11.00 pm, she is going to bed, and she is well falling asleep. In the afternoon she feels better. She has always been an emotionally sensitive person. The tachycardia rarely comes out. When she is in an emotional state, she does not have oversweating, but redness in her face. Since her childhood, she has always been an isolate and reserved person. Usually, she inclines to stay at home.

Antecedents: She is born following a prolonged delivery, induced by drugs. She has had the milk crust for a long time. Problems of recurrent tonsils infections occurred, but not since the first year of life. At school, she gained better notes in Italian.

Other: She has gall bladder troubles, and denies disbandment feelings but fainting feelings. No colic, no dyslalias, no difficulties in finding the right words occur.

Test therapy (daily doses, by the oral via): Glutamine 62.5mg; S-adenosil-l-methionine 100mg; Pyridoxine 75mg; Amitriptyline 10mg; Bromazepam 0.7mg; Carbamazepina 100mg.

Seconds tan days of March 2005, the first checkup.

After I asked her which result she had, she affirmed to be unchanged. She is not hyperosmic but cacosmia is appeared. Dysgeusia is as first, but she feels some taste (hypogeusia). The sleep is deeper and initially she was more rested. In this time she is more tired. The cool feeling unchanged. Currently she is eating fewer sweet things. Now she has her breakfast earlier, not to take drugs with empty stomach. She doesn't have anymore the feeling that the food rests on her stomach. The constipation is missing. Nocturia disappeared. She is going to bed a little later. Drooling during the sleep did not happen anymore.

At the morning, when she wakes up, she feels less asthenic, and mentally more active. Intrusive thinking decreased, and she has less need to count objects for no reason. The weeping is nearly missing. She has still intolerance moments to the noises and to confusion, but lesser. Now, she is a little better even during the morning. Faint feelings and sudden asthenias disappeared. The headaches attenuated.

Now, she is less sensitive. The mediastinal oppression reduced and the lump in the throat missed, as even the hunger of air. Perhaps she is reacting less with redness to his face. Socially, she is always isolated and reserved as first. Now, she goes out some more, but by herself. The possibility of finding the right words did not vary.

[Like it happened in other patients, the initial judgment doesn't correspond more to the final judgment, after the checkup of the course of many symptoms.]

Therapeutic variation (daily doses, by the oral via): Glutamine 125mg; S-adenosil-l-methionine 100mg; Pyridoxine 75mg; Amitriptyline 10mg; Bromazepam 1mg; Carbamazepine 100mg.

The second ten days of July 2005, the second checkup.

She did well off till June half. Then, had a relapse for no apparent reason. While she restarted to feel many odours, perfumes, the smell the cooked meat on the barbecue, the flowers, the lindens, now she has lost them again.

Therapeutic variation (daily doses, by the oral via): Glutamine 125mg; S-adenosil-l-methionine 100mg; Pyridoxine 75mg; Amitriptyline 10mg; Bromazepam 1mg; Carbamazepine 200mg.

 

The second ten days of February 2006, the third checkup, following 13 months of drug therapy. She is very satisfied and incredulous. Depression got over.

According to her, she recovered 99% the taste; Only the coffee sometimes has some burnt remains and the egg has a distant taste, which inclines a little to that of the rotten egg. For the remaining foods, no dysgeusia occurs. As for the sense of smell, she says it 90% improved. The odour of the kitchen gas is unpleasant. She recovered the odour of urine and faeces too, also of the own ones, but she feels not usual bad odours (some dysosmic ones). Now, she sleeps better, with less light sleeping. The headache during the menstrual period went over.

She would like to stop the drugs, but I advised her to be cautious and to arrive at least to 18 months, to stabilize the results.

The therapy did not have any change.

Discussion.

There are four points of this case surely interesting. 1. Before the loss of the era sense of smell, she was a person much sensitive to the odours, a feature that was reported even by other treated subjects. (Cocchi, 2002; Cocchi, 2004b; Cocchi, 2004c; Cocchi, 2004d; Cocchi, 2004e; Cocchi 2005b); 2. The loss of the sense of smell and subsequently of the taste occurred during a therapy with antibiotics. 3. The cacosmia, even investigated, was not referred at the first consultation and it has been reported only during the first checkup. Of fact it cannot be considered as an autonomous symptom (Cocchi 2005b). 4. The taste's recover appeared early of that of the sense of smell, and in wider way, a fact that is the upset of the above point two.

The response of Black to the test "Which is the opposite of the colour Red?" is a typical depressive answer, the equivalent of the popular saying "Today, I look on the dark side of things" (Cocchi, 2005a).

There is another point to observe. The therapy on the senses of smell and taste, first did not work. A short period of partial recover had full regression as its following, during the first six months of drug intake. The fact that meanwhile a series of other symptoms, both of the stress, and the depression started improving since the first checkup, did not have consideration by this patient. Only by doing specific questions I could find out the improvements occurred.

This means that not necessarily there is a prompt recover of the senses of the taste and the smell, following the drug therapy. Specific positive results, in this patient, came out after six months.

According to the patient, at the end check, 13 months later the beginning of the treatment, the recover of the taste had 99% evaluation versus 90% for the recover of sense of smell.

References.

Cocchi R. An anosmia-hyperosmia case with hypogeusia, from probable stress, Improved following an antistress  drug therapy. 2002 <www.stress-cocchi.net/Other1.htm>..

Cocchi R. A second case with hyperosmia-anosmia with ageusia (a taste trouble), improved following an antistress drug therapy. 2003c <www.stress-cocchi.net/Other8.htm>.

Cocchi R. A third case of anosmia-hyperosmia with ageusia, following stress and possible viral infection, improved with an antistress drug therapy. 2004a <www.stress-cocchi.net/Other7.htm>.

Cocchi R. A fourth case of anosmia, with cacosmia and ageusia, treated with antistress and antidepressant drug therapy. 2004b <www.stress-cocchi.net/Other10.htm>.

Cocchi R. Hyperosmia in a woman with atypical depression. His disappearance with the improvement of the depression. 2004c <www.stress-cocchi.net/Other13.htm>.

Cocchi R. Hyperosmia, and headache's fits from heavy, olfactory stimuli in a 35-years-old man of 35 years. An approach with antiepilectic and antistress drugs. 2004d <www.stress-cocchi.net/Other14.htm>.

Cocchi R. A case of melancholic depression with hyposmia, ageusia, cacosmia and tinnitus. Its evolution with antistress and antidepressant drug therapy. 2004e <www.stress-cocchi.net/Depression5.htm>.

Cocchi R. Another case of anosmia, hyperosmia, cacosmia, ageusia and dysgeusia in a 41-years old woman at the first consultation, and treated by antidepressants and antistress drugs. Luglio 2005b <www.stress-cocchi.net/Other20.htm>.

Cocchi R. The answer "White" to the test "Which is the contrary of the Red colour" and previous behaviour of "The Contrary Mary." an investigation on clinical reports of the years 2003-2004. 2005a <www.reversebrain.net/Domin16.htm>

Cocchi R. A case of intermittent cacosmia-phantosmia, without any anosmia, hyperosmia or ageusia, lasting 14 years, in a man of 40 years. Luglio 2005b <www.stress-cocchi.net/Other21.htm>.

 

Posted on internet on Aprile 14th, 2006. Copyright by Renato Cocchi, 2006.

 

Author's address: dr Renato COCCHI, via Rabbeno, 3

42100 Reggio Emilia

renatococchi@libero,it

 

Italian translation

Anosmia

Drug modulation of stress reactions

Stress symptoms

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