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.
Drug modulation of stress reactions
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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
Drug modulation of stress reactions
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