Background: Idiopathic intracranial hypertension (IIH) is a nervous disease characterized by increased intracranial pressure around the brain. It is induced by increased production or decreased reuptake of cerebrospinal fluid (CSF). The standard treatment of IIH includes medicines to reduce CSF production. Acetazolamide is the most commonly used drug in treating IIH and is also considered as the first-line treatment. Topiramate is used to treat obesity. Since obesity is a risk factor of IIH, topiramate is used to treat IIH. We investigated the effect of topiramate as an adjunct drug along with acetazolamide in patients with IIH who presented to Shahid Sadoughi Hospital in Yazd, central Iran.
Methods: This study was a double-blind clinical trial. Forty-eight IIH patients presenting to Shahid Sadoughi Hospital participated in the study, divided into two groups. The acetazolamide group received acetazolamide 750-1000 mg qd and the Acetazolamide+topiramate group received acetazolamide 750-1000 mg qd and topiramate 25-50 mg qd. CSF pressure, body mass index (BMI), and visual field were assessed at the beginning of treatment and 6 months after intervention. The gleaned data were analyzed with SPSS20 using statistical tests.
Results: Our findings showed significant differences in CSF pressure in acetazolamide group and CSF pressure, BMI, and visual field in acetazolamide+topiramate group at baseline and 6 months after treatment. There were also statistically significant differences between the mean score of retinal examination in IIH patients in both groups at second, fourth, fifth, and sixth months (P-value <0.05).
Conclusion: Topiramate can be used as an adjunct to acetazolamide to increase the effect of treatment in IIH patients.Â