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Dysosmia and drug tolerance with use of venlafaxine
  1. Celeste Rousseau1 and
  2. John Malaty2
  1. 1University of Florida, Gainesville, Florida, USA
  2. 2Community Health and Family Medicine, University of Florida Health, Gainesville, Florida, USA
  1. Correspondence to Dr John Malaty; malaty{at}


A 57-year-old woman presented with a 1-year history of major depressive disorder. She was started on venlafaxine XR 75 mg orally daily and a few days later developed severe dysosmia to foods she used to enjoy. She never had previous problems with smell or taste. At her 1-month follow-up, her depressive symptoms had improved, but she reported persistent dysosmia and was found to have associated weight loss due to decreased oral intake. She was advised to switch medications, but due to financial constraints she continued taking the same dose. At follow-up 48 days later, she reported complete resolution of her dysosmia and was eating normally again, but she had persistence of some depressive symptoms so her dose was gradually increased to venlafaxine XR 225 mg orally daily until her depressive symptoms and postmenopausal hot flashes were well controlled. There were no changes with continued use over the following 8 years.

  • psychiatry (drugs and medicines)
  • unwanted effects/adverse reactions
  • ear
  • nose and throat/otolaryngology
  • medical management
  • depressive disorder

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  • Contributors CR and JM meet the following requirements for authorship: substantial contributions to the conception or design of the work; or the acquisition, analysis or interpretation of data for the work; and drafting the work or revising it critically for important intellectual content; and final approval of the version to be published; and agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. Specifically CR reviewed the medical facts, did literature review, wrote draft, made edits to revised version, reviewed and approved the final version and agrees to be accountable for all aspects of this case report. Specifically JM primarily cared for this patient and conceived the case report, reviewed the medical facts, did literature review, discussed and planned with CM, reviewed and made edits to the draft to create the revised version, approved of the final version and agrees to be accountable for all aspects of this case report.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.