Triggered by Weather? This Medication May Help

By Sarah Hackley

It’s fall in Texas, which means one to two months of intense oscillations between 90+ degree, summer-like temperatures and 30-50 degree winter temperatures – all within the same week, if not (as often happens) the same day. For those of us whose migraine disease is dramatically impacted by frequent, severe weather changes, this generally means a season of increased disability and weeks of illness. One medication, however, may be able to help.

Diamox for migraine symptoms

Acetazolamide, also called Diamox, is a medication used to treat acute altitude sickness, such as that brought on by mountain climbing, and open-angle glaucoma. Like Topamax, a drug commonly used as a migraine preventative, acetazolamide inhibits a type of enzyme called carbonic anhydrase, and both have been used to treat seizure disorders (although Diamox is used much less frequently than Topamax).

Research results for Diamox

The use of the drug in connection with migraine appears to have started with familial hemiplegic migraine. Doctors prescribed the drug off-label as a way to treat migraine patients with specific symptoms, primarily vertigo and loss of muscle coordination. Off-label usage then spread to other migraineurs over the years, particularly those suffering from vestibular migraine or severe menstrual migraine. Recently, some doctors started prescribing the medication off-label for patients suffering from frequent weather-related migraine. There is some evidence that the drug may interrupt cortical spreading depression, and at least one study has shown good results, especially in migraine patients with aura.

A 2002 randomized-controlled study, however, found almost no difference between a 500 mg daily dose of acetazolamide and a placebo pill. However, the study involved only 53 patients and was prematurely stopped because approximately one-third of participants withdrew early due to unwanted side effects (primarily nausea, a “pins and needles” feeling, and/or a lack of energy).Diamox side effectsSide effects do seem to be a major problem for some patients, and some less common but severe side effects rule it out entirely as an option for others, especially those with liver or kidney disease. Despite this, many patients prescribed acetazolamide claim success with the drug, saying they’ve experienced a marked improvement in migraine frequency, severity, and/or symptoms – especially ataxia and vertigo. (Some of our Migraine.com readers also have tried this medication for prevention, though with mixed results. You can read more, or join the conversation, here.)May be worth it?While I haven’t tried this medication yet, I’d like to. Weather changes are a major trigger for me, and I do have aura. I also experience intense vertigo and lightheadedness with my attacks – symptoms my neurologists have previously said can’t be treated with typical migraine medications. If this medication can help with those symptoms, my ability to function during an attack would improve drastically. Even with the potential side effects, I feel it’s worth at least discussing with my doctor next month. Who knows? It could help.How about any of you? Have you ever tried or been prescribed Diamox for migraine relief or prevention? If so, what was your experience like?

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falcon6
My headaches nd migraines are most certainly affected by weather. I have never tried this drug, but did try Topamax. The side effects were terrible! My memory got to the point of being so bad that I didn't remember things like typing up my mom's will or what I had said 5 minutes before. I can't remember places I have been, even though I may have been there several times. I lost my ability to converse with people because I would forget my words! Or the words would be in my head but I couldn't get them to come out of my mouth. If Diamox is similar to Topamax, NO THANK YOU!!!
1. amandak
 Ms. Piggy-- I too tried Topamax during the beginning of my adult migraine treatment journey, and I also found that the "dopamax" symptoms (memory, brain fog, feeling stupid 100% of the time I took it on the lowest dose, going to a friend's grand opening of a designer boutique storefront and trying to smell a $65 candle... that I didn't notice was lit WITH FIRE and hot wax.... and dropping it and spilling BLACK, HOT wax all over the floor and merchandise) were far too much to tolerate. But I've recently started Diamox and found it to be both more effective and the side effects much more tolerable, if not so extreme. I'm tired the morning after I take it and I have to make sure my electrolytes are good since it makes you wiz like a race horse, but I don't feel like I've sheered the top numbers off my IQ. Until there is something better for prevention, I'm happy to have this option for living in "the worst city in the US for Migraine" and helping to prevent my Hemiplegic Migraines.
2. Sarah Hackley Moderator
 Thank you for sharing your experiences with us, AmandaK! It's nice to hear from someone who has tried Diamox as a preventative. I don't know many others who have. I wish you continued success with your treatment.
patchwork
My neurologist prescribed it to me to be taken as needed, specifically prior to flying on a plane or any time I travel involving significant altitude changes. I've also taken it when I know a major weather change is headed our way. It has worked for me using it on an as needed basis, though it does have some unpleasant side effects for me (nausea, dizziness, drowsiness). I have to take it with Phenergan (promethazine) or Vistaril (hydroxyzine) to combat the nausea. Due to the side effects I'm not sure I'd want to use Diamox as a daily preventative, although maybe the side effects would decrease over time as the body adjusts to the medication.
1. Brooke H Moderator
 Hi Patchwork, Thank you for taking the time to share your experience with Diamox. We're glad to hear that it's been helpful in those situations that can certainly trigger migraine. Please come here anytime for support or on our facebook page: <a href='https://www.facebook.com/MigraineDotCom/?fref=ts' target='_blank' rel='noopener noreferrer nofollow'>https://www.facebook.com/MigraineDotCom/?fref=ts</a> (if desired). Best, Brooke (Migraine.com team)
2. Sarah Hackley Moderator
 Thank you so much for sharing your story with us! I haven't heard from many who have had this prescribed to them so your response is helpful. Thank you!
mrst53
I live in Virginia and the weather is always up and down and it rains one day and is pretty the next. My migraines are mostly due to the weather, altho both of my grandmothers had them, so I guess I am doomed anyway. I have been on Diamox and Topamax for years. Niether of them have helped for the weather migraines. Currently I am downsizing the Topamax. I have had migraines almost every day for the last 2 weeks. We have had bad weather, so I don't know if its the weather or downsizing of the meds. Who knows.
1. Sarah Hackley Moderator
 Teasing out the triggers can be tough. I live in central Texas, so I understand crazy weather. I'm sorry you've lived with them for so long, but maybe you'll get some relief once the season stabilizes. Do you find certain seasons are worse for you?
leilanirl
I, too, am sensitive to barometric pressure and wind. I used Diamox, but I didn't use it long enough to feel any affects. If you use this medicine, you become sensitive to the sunlight, and I am a long distance runner. I couldn't get past that side effect. I've heard good things though. My doctor said I'm basically suffering from chronic "altitude sickness" and suggested that I go on a Ketogenic diet instead of using Diamox. After some research, I learned that mountain climbers use this diet to fight the affects of high altitudes. I went on the diet last September and I was virtually migraine-free until August. I still had the monthly menstrual migraine, but it never lasted more than 2 hours. Sometimes they lasted only minutes. But ever since the hurricanes and tropical storms hit us, I've been chronic again. Truthfully, I've slipped off the diet during the hurricanes because of what was available. But it's been several months already and I've been REALLY strict with my diet. I should be feeling better now. Now I have a new symptom... left ear ache during the aura phase and I am literally disabled and nauseous and sometimes vomiting. Before, I was able to drive with my episodes, and able to work. But now, it's really, really difficult. I'm in a lot of pain. 🙁
1. Sarah Hackley Moderator
 I'm sorry you're struggling so much. I get ear pain during the aura phase, too, though mine is on my right side (which is the side my attacks tend to strike). I've heard of the Ketogenic diet, but never in this context. That's interesting, and I might have to try that. I hope you get to feeling better soon. Have you discussed your new symptom and increased pain levels with your doctor?
yahcqa
I have tried acetazolamide but had to stop due to scary side effects. My pharmacist told me to stop immediately because my heart was doing funky things while on it. I wish I'd been able to stay on it to see if it would have helped.
deedeevee1
I take it currently. It did help with the vertigo immensely. Also with the swishing in my ear. But I also have, in addition to intractable migraine disease, idiopathic intracranial hypertension. Also known as pseudo tumor. But it kills my stomach!! I can only take it every other day. It caused me a significant amount of gastric issues. Good luck!! I hope it won't affect you as poorly!!
punkyb
I have a 2cm left cavernous sinus Schwannoma and Diamox has worked the best to helped me with migraines. I have constant headaches with frequent migraines (also double vision etc.) and I have tried many different medications and despite the side effects (numbness in hands and feet and peeing a lot), I rather take this medication as needed treat oncoming migraines. Just remember to drink enough water to prevent any renal issues.
1. Peggy Artman Moderator
 Punkyb, thanks for joining our community forum. I have heard of others that have had good results with Diamox. That’s interesting that you take it to treat oncoming migraines. I hope this continues to help you! ~ Peggy (Migraine.com Team)