Olfactory cocainization is not an effective long-term treatment for phantosmia

Chem Senses. 2013 Nov;38(9):803-6. doi: 10.1093/chemse/bjt047. Epub 2013 Oct 11.


Phantosmia, the perception of an odor when there are no odorants in the environment, can be a very debilitating symptom. In the 1960s, Zilstorff reported olfactory distortions could be treated by the topical application of a cocaine solution to the olfactory epithelium. In evaluating this treatment, we observed no long-term benefit using cocaine on 6 patients with phantosmia. Based on our observations, the patient's olfactory ability was not a determining factor in the initiation or quality of their phantosmia. Following topical cocainization, we observed a remarkable delay of hours to days in the return of olfactory ability, and when cocaine was applied to only 1 nostril, there was a decreased olfactory ability on the noncocainized side. These results may suggest the possibility that phantosmia is related to a central processing problem.

Keywords: cocaine; nasal airflow; olfactory cleft; olfactory neuron; smell distortion.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Cocaine / pharmacology*
  • Cocaine / therapeutic use*
  • Dopamine Uptake Inhibitors / pharmacology
  • Dopamine Uptake Inhibitors / therapeutic use
  • Female
  • Humans
  • Male
  • Middle Aged
  • Olfaction Disorders / drug therapy*
  • Olfactory Mucosa / drug effects*
  • Olfactory Mucosa / physiopathology
  • Smell / physiology
  • Time Factors


  • Dopamine Uptake Inhibitors
  • Cocaine