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Medication linked to metallic taste

Dear Dr. Gott: I am an 80-year-old widow. Five months ago, I started having a metallic taste in my mouth, a sore tongue and a dry mouth. My first thought was that it might be a bad tooth or filling, but my dentist ruled that out.

Then I discovered the problems were because of citalopram, a medication I had been taking for one and a half years. My doctor cut my dosage in half, but that didn't rid me of the side effects. I tried two other medications: One was the same with a different name, and the other made me nauseated. At the present time, I am not taking any of these.

My problem now is that I don't know where to go for relief. Nothing tastes good, not even water. Any advice you can offer will be greatly appreciated. I hope you can shed some light on my problem because so far I haven't been able to get any answers.

Reply: The citalopram you were prescribed has a number of side effects, several of which include dry mouth, nausea, arthralgias and taste perversion. To switch to another name in the same category of drugs likely continued the problem.

There are a great number of possible reasons for metallic mouth. Some of the more common causes are the use of antibiotics, medications taken for depression, heart failure, rheumatoid arthritis, kidney stones, hypertension, diabetes and calcium-carbonate supplements.

Because you do not provide a medical history, I am unable to pinpoint a possible cause; however, a return visit to your physician or a specialist might be just the ticket. By ruling out conditions you do not have, you can better investigate any you are currently being treated for.

While I do not profess to know specifically why the citalopram was prescribed, you might speak with your doctor to determine whether he or she could recommend something in another class of drugs that might work for you. Or ask for an opinion on a trial of St. John's wort, valerian, tai chi or yoga.

There are several reasons why some people should not use herbs, so review your medication list with your physician before taking any action. It is also important to understand that medications are often prescribed for entirely different reasons than they were originally intended.

In the interim, maintain good oral hygiene, making sure to brush your tongue when you brush your teeth. Consider using plastic utensils for eating to see whether the metallic taste disappears.

Dear Dr. Gott: Recently, after being on my feet for up to ten hours, I got a rash around my ankles and the tops of my feet, and sometimes it goes up my legs. Tender to the touch, it is more noticeable the longer I am on my feet. It disappears after a few days if I'm not on my feet constantly.

Reply: Common causes of foot rash are dry skin, heat exposure, fungus and spider-vein itch. If your feet are dry, rub them with a lanolin-based cream. If heat could be the culprit, change to footwear such as sandals or canvas sneakers, and wear light cotton socks. Fungal infection might be treated with a topical medicated product or a trip to your physician for a prescription. Spider-vein itch is treated with elastic stockings and alternative remedies.