Q. My grandmother used to keep smelling salts in her cabinet. Can they really help someone who feels faint?
They can, but it depends on what is causing the person to feel faint. Ammonia inhalants, or smelling salts, have a long history of use in rousing people who feel faint or have passed out. They were especially popular during the Victorian era, when English policemen would carry them in a vial (called a “lady reviver”) to help women afflicted with fainting fits (perhaps attributable at least in part to the tight corsets that were the fashion then).
The active ingredient, ammonium carbonate—which is sometimes combined with scents like lavender, lemon, or nutmeg oil—is extremely irritating to the nasal passages. The intense stimulus may help revive someone who has fainted as a result of orthostatic hypotension (a drop in blood pressure upon standing) or due to a vasovagal episode (a usually harmless, involuntary reflex of the nervous system that’s triggered by such factors as emotional stress, fear, or the sight of blood). But nearly always, people will quickly revive on their own after fainting just by lying down. And smelling salts won’t work if someone loses consciousness due, for instance, to an arrhythmia (abnormal heart rhythm) or seizure.
Today, smelling salts are often used to help athletes, particularly boxers, regain alertness after being dazed or knocked out from a head injury. The problem is that this may prevent the athlete from being properly evaluated and diagnosed, and could potentially mask the seriousness of the injury. And if the smelling salts are held too close to the nose, the injured athlete may, upon the first whiff of ammonia, jerk his or her head and aggravate an unrecognized neck injury.
In recent years, many athletes have also been using smelling salts—sometimes called “the new steroids”—as a pre-game stimulant or mid-game “pick-me-up” in hopes that the “rush” will enable them to perform better. But there is no conclusive evidence that this works. For instance, a small 2014 study in the Journal of Exercise Physiology found that using ammonia inhalants did not significantly increase the number of bench presses or back squats performed by fit young men, compared to a placebo inhalant. However, a small 2018 study in the Journal of Strength and Conditioning Research did observe some improvement in strength and power performance.
BOTTOM LINE: There seems to be no harm in using smelling salts if you occasionally feel faint, as long as you don’t have asthma or another respiratory condition and as long as you don’t hold them too close or use them too often. But from a medical standpoint, there’s no reason to use them, and the risk of harm could outweigh any benefit.
