This is the first in a 100-part series of blogs on various migraine drugs. Yes, we do use that many drugs to treat migraines, although only a handful are FDA-approved for migraines. Many of these drugs are in the same family, but they are all somewhat different from each other.
Acetazolamide (Diamox) is a diuretic (water pill), which is used to treat mountain sickness. Unlike other diuretics, it is somewhat selective in removing extra fluid from the brain and the lungs, rather than equally from all parts of the body.
Migraine sufferers whose migraines are triggered by traveling to high altitudes can sometimes prevent these migraines by taking acetazolamide the day before their ascent and then throughout their stay at high altitude. A handful of my patients continued to take acetazolamide even after they returned to the sea level because they found it to be effective in preventing all of their migraines. These patients tended to have barometric pressure changes as their main migraine trigger. For people who get only occasional weather-related headaches, taking acetazolamide daily is not necessary. However, they can often prevent an attack by taking the drug the day barometric pressure drops and for as long as the pressure fluctuates.
To avoid having to constantly watch the weather forecast, a couple of apps can send you a warning whenever barometric pressure drops (it usually takes a drop of 20 millibars of pressure to trigger a migraine). One such free app is MigraineX.
Interestingly, people who live at high altitudes tend to have more migraines than those living aa the sea level.
Acetazolamide is also used to treat headaches due to increased intracranial pressure (pressure inside the skull).
Acetazolamide is available in 125 mg, 250 mg, and an extended release, 500 mg tablets. The usual starting dose is 250 mg once a day. Potential side effects include tingling of your face and extremities, dizziness, altered taste (carbonated beverages have a very unpleasant taste), and with long-term daily use, kidney stones.
