Medications for lost smell? Try these out!

I recently came across a review article that talked about medications that are being tried for hyposmia, which is decrease in the sense of smell. We’re seeing more and more patients come in with hyposmia after having a COVID-19 infection. It really is very common and can last for months and for some patients, unfortunately, can be permanent. By far the easiest and first line therapy should be olfactory rehab. I’ve written how to do that already on this link. 

There are other medications that are being studied, but there is not a great amount of research, so take these recommendations knowing that.  

—The first thing I would consider is using fish oil. There have been some small studies using omega-3 fatty acids (found in fish oil capsules) that did show that patients had improvement in their ability to smell, even with long-term cases of hyposmia. Besides that, fish oil is easily available, cheap, and is extremely low risk.

—Another option is nasal steroid rinses. These have been used for many years in patients who have other inflammatory nasal diseases like polyps. There is a small study that does show that this could be helpful, but would require being seen by an ENT who is familiar with prescribing nasal steroid irrigations.  

—Theophylline is a medication that is used for patients with asthma since the 1920’s, and several studies show some degree of effectiveness in patients who have hyposmia. Unfortunately, it can cause several side effects at higher levels and blood concentrations have to be checked to make sure that a patient’s levels aren’t too high. This makes it a bit of a tricky medication to prescribe.  

So there you have it. There’s quite a bit of research that is on going with not only these medications but also several others such as intranasal sodium citrate, stem cell therapy and platelet rich plasma (which is injected into the nasal smelling center…ouch!).  There’s a lot out there that’s being done to try to improve patients’ sense of smell after COVID, but it’s probably going to take at least a few more years before we have more answers.