01/14/2026
❇️For many years, long before the pandemic, physicians (including myself) had considered using neuromodulators - medications such as gabentin, pregabelin and amitriptyline - to help patients with parosmia (distorted smell and taste).
❇️Some excitement occurred at the beginning of the pandemic when some patients seemed to respond to gabapentin,(shoutout to DO YEON CHO - who published that case series!) although it was a small number of patients and there was no control group in that study.
🛑Unfortunately, once gabapentin was run through a randomized controlled trial, (shoutout to Jay Piccirillo and his group at WashU who carried out that study) the conclusion was that gabapentin does NOT actually help patients with COVID-19 induced parosmia.
✴️As one of the criticisms of that trial was that the dose was too high to be well tolerated, and I have been treating patients with various neuromodulators and dosing ranges over the last 15 years with varying results, I asked our visiting scholar Kasia Resler to look into our patient outcomes.
❌This demonstrated that although parosmia in some patients improves over time, this is not linked consistently to treatment with gabapentin, pregabalin or amitriptyline. Rigorous scientific methodology is what allows us to differentiate between coincidence and spontaneous resolution, and real interventional differences. I’ll keep studying this disease process to find something that works for patients with this highly impactful problem! (Maybe electrical neuromodulation is the answer - working in that now!)
Link to our study just published in Rhinology here https://lnkd.in/gJ8wQetd
Stanford OHNS
