BMJ 2001;322:48 ( 6 January )

Letters

Pharmacological prevention of acute mountain sickness

    Many climbers and trekkers find acetazolamide 500 mg/day to be useful
    Same ascent rates must be used to assess effectiveness of different doses of acetazolamide
    Authors' reply

Many climbers and trekkers find acetazolamide 500 mg/day to be useful

The first 150 words of the full text of this article appear below.

EDITOR---Dumont et al reach a false, potentially harmful conclusion in their paper on the efficacy and harm of pharmacological prevention of acute mountain sickness.1 Their claim that acetazolamide 500 mg/day does not work in preventing acute mountain sickness must be challenged. Their analysis is flawed for three reasons.

Firstly, they used only nine of 25 available controlled studies, and analysed only four of 10 trials with acetazolamide 500 mg/day. Consequently, only 143 individuals taking acetazolamide 500 mg/day were included, 120 from one study.2 In that investigation the rate of ascent in one of the two trials was so slow that acetazolamide made no difference in acute mountain sickness scores. The other trial, with faster rate of ascent, showed acetazolamide to be very effective. Another meta-analysis, of 10 trials of acetazolamide 500 mg/day (306 participants), concluded that it was effective.3 If Dumont et al included more trials they would find that acetazolamide 500 mg/day is indeed effective.

Secondly, rate . . . [Full text of this article]
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Relevant Article

Efficacy and harm of pharmacological prevention of acute mountain sickness: quantitative systematic review
Lionel Dumont, Chahé Mardirosoff, and Martin R Tramèr
BMJ 2000 321: 267-272. [Abstract] [Full Text] [PDF]

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