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The Neurological Spectrum for Acetazolamide Pharmacotherapy: from Basic Science to Clinical Applications

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Abstract

Acetazolamide was developed nearly 70 years ago and continues to be used for niche indications. Mechanisms of action are relatively less well-studied than clinical applications. Several potential uses span the spectrum of neurological illnesses, but yet neurological side effects complicate short- and long-term applications for many patients. This review examines the basic science and clinical usages of acetazolamide germane to neurological and psychiatric spectrums. The existing publications were reviewed from the time of the drug’s inception to April 2021. This review utilized access as available in PubMed, EMBASE, CINAHL Plus, and the Cochrane Library. Acetazolamide is firmly established as first-line prevention for altitude sickness. Outside of declining use for glaucoma, most other medical indications are few, highly selective, and/or partially beneficial. In the past, carbonic anhydrase inhibition has been the proposed mainstay of acetazolamide’s mode of action, but more contemporary studies have focused on cellular membrane ion/water channel activity. Prolonged use of acetazolamide is nevertheless likely to be limited due to common adverse events unless more effective mitigating approaches are discovered. A better understanding of acetazolamide’s clinical impact and molecular mechanisms is sure to elaborate on both healthy physiological mechanisms and disease.

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  1. Department of Pathology and Laboratory Medicine, The University of British Columbia, Vancouver, BC, Canada

    Nevio Cimolai

  2. Department of Pathology and Laboratory Medicine, Children’s and Women’s Health Centre of British Columbia, 4480 Oak Street, Vancouver, BC, V6H3V4, Canada

    Nevio Cimolai

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Cimolai, N. The Neurological Spectrum for Acetazolamide Pharmacotherapy: from Basic Science to Clinical Applications. SN Compr. Clin. Med. 3, 2576–2592 (2021). https://doi.org/10.1007/s42399-021-01067-z

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