Topiramate is more effective than acetazolamide at lowering intracranial pressure

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Topiramate is more effective than acetazolamide at lowering intracranial pressure. / Scotton, William J; Botfield, Hannah F; Westgate, Connar Sj; Mitchell, James L; Yiangou, Andreas; Uldall, Maria S; Jensen, Rigmor H; Sinclair, Alex J.

In: Cephalalgia, 13.06.2018.

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Scotton, William J ; Botfield, Hannah F ; Westgate, Connar Sj ; Mitchell, James L ; Yiangou, Andreas ; Uldall, Maria S ; Jensen, Rigmor H ; Sinclair, Alex J. / Topiramate is more effective than acetazolamide at lowering intracranial pressure. In: Cephalalgia. 2018.

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@article{1d69e16c434c43b5a62a1731df15ee4a,
title = "Topiramate is more effective than acetazolamide at lowering intracranial pressure",
abstract = "Background The management of idiopathic intracranial hypertension focuses on reducing intracranial pressure to preserve vision and reduce headaches. There is sparse evidence to support the use of some of the drugs commonly used to manage idiopathic intracranial hypertension, therefore we propose to evaluate the efficacy of these drugs at lowering intracranial pressure in healthy rats. Methods We measured intracranial pressure in female rats before and after subcutaneous administration of acetazolamide, topiramate, furosemide, amiloride and octreotide at clinical doses (equivalent to a single human dose) and high doses (equivalent to a human daily dose). In addition, we measured intracranial pressure after oral administration of acetazolamide and topiramate. Results At clinical and high doses, subcutaneous administration of topiramate lowered intracranial pressure by 32% ( p = 0.0009) and 21% ( p = 0.015) respectively. There was no significant reduction in intracranial pressure noted with acetazolamide, furosemide, amiloride or octreotide at any dose. Oral administration of topiramate significantly lowered intracranial pressure by 22% ( p = 0.018), compared to 5% reduction with acetazolamide ( p = >0.999). Conclusion Our in vivo studies demonstrated that both subcutaneous and oral administration of topiramate significantly lowers intracranial pressure. Other drugs tested, including acetazolamide, did not significantly reduce intracranial pressure. Future clinical trials evaluating the efficacy and side effects of topiramate in idiopathic intracranial hypertension patients would be of interest.",
keywords = "Cerebrospinal fluid, Idiopathic intracranial hypertension, Headache, Choroid plexus",
author = "Scotton, {William J} and Botfield, {Hannah F} and Westgate, {Connar Sj} and Mitchell, {James L} and Andreas Yiangou and Uldall, {Maria S} and Jensen, {Rigmor H} and Sinclair, {Alex J}",
year = "2018",
month = jun,
day = "13",
doi = "10.1177/0333102418776455",
language = "English",
journal = "Cephalalgia",
issn = "0333-1024",
publisher = "SAGE Publications",

}

RIS

TY - JOUR

T1 - Topiramate is more effective than acetazolamide at lowering intracranial pressure

AU - Scotton, William J

AU - Botfield, Hannah F

AU - Westgate, Connar Sj

AU - Mitchell, James L

AU - Yiangou, Andreas

AU - Uldall, Maria S

AU - Jensen, Rigmor H

AU - Sinclair, Alex J

PY - 2018/6/13

Y1 - 2018/6/13

N2 - Background The management of idiopathic intracranial hypertension focuses on reducing intracranial pressure to preserve vision and reduce headaches. There is sparse evidence to support the use of some of the drugs commonly used to manage idiopathic intracranial hypertension, therefore we propose to evaluate the efficacy of these drugs at lowering intracranial pressure in healthy rats. Methods We measured intracranial pressure in female rats before and after subcutaneous administration of acetazolamide, topiramate, furosemide, amiloride and octreotide at clinical doses (equivalent to a single human dose) and high doses (equivalent to a human daily dose). In addition, we measured intracranial pressure after oral administration of acetazolamide and topiramate. Results At clinical and high doses, subcutaneous administration of topiramate lowered intracranial pressure by 32% ( p = 0.0009) and 21% ( p = 0.015) respectively. There was no significant reduction in intracranial pressure noted with acetazolamide, furosemide, amiloride or octreotide at any dose. Oral administration of topiramate significantly lowered intracranial pressure by 22% ( p = 0.018), compared to 5% reduction with acetazolamide ( p = >0.999). Conclusion Our in vivo studies demonstrated that both subcutaneous and oral administration of topiramate significantly lowers intracranial pressure. Other drugs tested, including acetazolamide, did not significantly reduce intracranial pressure. Future clinical trials evaluating the efficacy and side effects of topiramate in idiopathic intracranial hypertension patients would be of interest.

AB - Background The management of idiopathic intracranial hypertension focuses on reducing intracranial pressure to preserve vision and reduce headaches. There is sparse evidence to support the use of some of the drugs commonly used to manage idiopathic intracranial hypertension, therefore we propose to evaluate the efficacy of these drugs at lowering intracranial pressure in healthy rats. Methods We measured intracranial pressure in female rats before and after subcutaneous administration of acetazolamide, topiramate, furosemide, amiloride and octreotide at clinical doses (equivalent to a single human dose) and high doses (equivalent to a human daily dose). In addition, we measured intracranial pressure after oral administration of acetazolamide and topiramate. Results At clinical and high doses, subcutaneous administration of topiramate lowered intracranial pressure by 32% ( p = 0.0009) and 21% ( p = 0.015) respectively. There was no significant reduction in intracranial pressure noted with acetazolamide, furosemide, amiloride or octreotide at any dose. Oral administration of topiramate significantly lowered intracranial pressure by 22% ( p = 0.018), compared to 5% reduction with acetazolamide ( p = >0.999). Conclusion Our in vivo studies demonstrated that both subcutaneous and oral administration of topiramate significantly lowers intracranial pressure. Other drugs tested, including acetazolamide, did not significantly reduce intracranial pressure. Future clinical trials evaluating the efficacy and side effects of topiramate in idiopathic intracranial hypertension patients would be of interest.

KW - Cerebrospinal fluid

KW - Idiopathic intracranial hypertension

KW - Headache

KW - Choroid plexus

U2 - 10.1177/0333102418776455

DO - 10.1177/0333102418776455

M3 - Article

C2 - 29898611

JO - Cephalalgia

JF - Cephalalgia

SN - 0333-1024

ER -