Anorexia in Patients with Smell Loss (Hyposmia) Corrected by Treatment with Intranasal Theophylline

Abstract

Patients with many disease processes including cancer, diabetes, hypothyroidism, viral infections, head injury, neurodegenerative disorders and other pathologies exhibit hyposmia, loss of ability to obtain flavor from food and subsequent anorexia and weight loss. While oral theophylline has been useful in correcting hyposmia in several of these clinical groups this drug has significant somatic side effects; its efficacy is both dose and time dependent and patients can develop drug resistance. In an effort to develop a more clinically beneficial method for treatment of hyposmia an open label, single source clinical trial was performed in 10 patients with hyposmia who were each studied before and after treatment with both oral and intranasal theophylline. On oral theophylline smell function improved in eight of the 10 patients; patients gained 3.4±0.9 lbs (Mean±SEM) over baseline. On intranasal theophylline smell function improved further in eight of 10 patients; patients gained an additional 4.5±1.4 lbs over that gained on oral theophylline. These data indicate that intranasal theophylline not only corrects hyposmia, as shown previously with oral theophylline, but also appears to improve appetite through increased ability to obtain flavor from food with subsequent enhancement of weight gain. This effect of intranasal theophylline occurs within days of treatment rather than after months of treatment with oral theophylline. Since many patients with several disease processes exhibit hyposmia with subsequent anorexia, treatment of these patients with intranasal theophylline appears to be a useful, novel method for improvement of both hyposmia and anorexia and superior to treatment with oral theophylline.