Medication Summary
Diuretics may be helpful in cases of elevated intracranial pressure. Diamox and other carbonic anhydrase inhibitors can decrease the production of CSF.
Carbonic anhydrase inhibitors
Class Summary
Can be used in selected cases because they decrease the production of CSF and, thus, lower intracranial pressure.
Acetazolamide (Diamox, Diamox Sequels)
The conversion of carbon dioxide to bicarbonate plays a key role in the production of both aqueous humor and CSF. Carbonic anhydrase inhibitors act by inhibiting the conversion of carbon dioxide to bicarbonate, thus inhibiting the production of both aqueous humor and CSF. Dosage should be individualized and up to 2 g per day may be required in patients with idiopathic intracranial hypertension. However, many patients cannot tolerate more than 1 g/d because of the adverse effects (eg, dizziness, metallic taste, lethargy, paresthesias). Diamox sequels may be better tolerated than tablets.
Corticosteroids
Class Summary
May be useful in cases where inflammatory lesions lead to a secondary elevation in CSF pressure. These drugs are effective in these cases because of their potent anti-inflammatory effects.
Prednisone (Deltasone)
Prednisone, like other corticosteroids, can cause profound and varied metabolic and immunologic effects. Its usefulness in these cases stems from its strong anti-inflammatory properties.
