Effects of therapeutic doses of amiloride and hydrochlorothiazide on taste, saliva and salt intake in normotensive adults

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Abstract
Tentative evidence suggests that hydrochlorothiazide (HCTZ) and amiloride may alter salivary function, taste sensitivity and dietary intake. The effects of these diuretics on salivary flow and composition, taste attributes (i.e. recognition thresholds, perceived intensity ratings and preference) as well as sodium intake were further examined in 73 normotensive adults in a double-blind, placebo-controlled, cross-over study. Following random assignments to one of three groups [5 mg twice per day of amiloride (n = 24), 50 mg/day of HCTZ (n = 24) or placebo (n = 25)], subjects took appropriate placebos for 2 weeks, active drug for 8 weeks and placebo for 3 weeks. Relative to baseline values, amiloride treatment resulted in a significant 39% decrease in stimulated salivary sodium levels and a 28% decline in NaCl recognition thresholds. HCTZ significantly stimulated sodium intake as the sodium/creatinine ratio was ˜50% higher following 4 weeks of drug use relative to baseline values. Subjects were subjectively unaware of these changes. Potential mechanisms and clinical implications of these findings are considered.

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