Triggered by Weather? This Medication May Help
Last updated: October 2022
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.
What is Diamox (acetazolamide)?
Acetazolamide, also called Diamox, is a medication used to treat glaucoma and high-altitude sickness, such as that brought on by mountain climbing. 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).1
When was Diamox first used to treat migraine?
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.2 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.3
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).4
Should I be concerned about side effects?
Side 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.)
Is it worth a try?
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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