To the Editor.—
In a recent QUESTIONS AND ANSWERS (1983;249:1770), a question was raised concerning the prophylaxis of and therapy for highaltitude headache. I believe that Dr Dalessio's reply requires clarification and amplification.Headache occurring at high altitude is the most common manifestation of a broader constellation of symptoms, termed acute mountain sickness (AMS), that may include nausea, vomiting, anorexia, lassitude, and insomnia. Acute mountain sickness is the most common form of high-altitude illness, occurring to a variable extent in many sojourners higher than 2,400 m (8,000 ft), often after vigorous exercise or sleep at high altitude.Acetazolamide, a carbonic anhydrase inhibitor, has been shown to provide effective prophylaxis against the symptoms of AMS1,2 but is not of proved therapeutic benefit in established AMS. A reasonable prophylactic regimen might be 250 mg every eight hours for 32 hours before and 40 hours after ascent.1 The mechanism of benefit
Mountain RD. Treatment of Acute Mountain Sickness. JAMA. 1983;250(11):1392. doi:10.1001/jama.1983.03340110016014
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