Stanford Hospital & Clinics and a clinical assistant professor at the Stanford University School of Medicine, has found that a widely available, over-the-counter (OTC) drug may help with altitude, or acute mountain sickness (AMS). Details of his research have been published this week in Annals of Emergency Medicine.
Grant Lipman, MD says that mountain sickness can feel like a bad hangover with the headache, fatigue, dizziness, nausea, vomiting and poor appetite to go with it. His recent study aimed at finding a way to improve the problem for sufferers. Ibubrofen is one of the most common OTC drugs used against inflammation; it is also a painkiller. It’s popular with athletes for its anti-inflammatory properties.
Lipman’s study took 86 men and women and used double-blind and placebos to look into the effects of Ibuprofen on altitude sickness. It’s an important issue for those in the mountains, because it’s not just the discomfort and lack of productivity that is a problem. If left untreated, it can cause cerebral edema, a swelling on the brain that in many cases becomes fatal.
“You don’t want to feel horrible for 15 to 20 percent of your vacation … Ibuprofen could be a way to prevent AMS in a significant number of the tens of millions of people who travel to high altitudes each year.”
In Lipman’s study the 58 men and 28 women traveled to the White Mountains, near Bishop, California. They stayed overnight at 4,100 feet and took 400mg of ibuprofen. The next morning they went to 11,700 feet, took a second dose at 2pm and then hiked up to 12,570 feet, and took a third dose at 8pm, and spent the night on the mountain.
43% of those on the drug had symptoms of altitude sickness.
69% of those on the placebo had similar issues, showing the drug reduced the altitude sickness rate. Although a reduction in symptoms was not considered significant, overall, those on the placebo seemed to show slightly worse symptoms.
It’s not understood exactly why mountain sickness occurs, although the thinner air with less oxygen is clearly the cause. One theory suggests that the body, in trying to deal with less oxygen, ends up pumping more fluids to the brain which then causes an inflammation or swelling.
Although there are medications for the problem, acetazolamide and dexamethasone are two examples, they have draw backs. Dexamethasone has been linked to hyperglycemia, adrenal suppression, delirium, depression, insomnia and mania, while Acetazolamide’s can cause nausea, dizziness and fatigue, much like the altitude sickness itself.
Lipman says :
“We suggest that availability alone makes ibuprofen an appealing drug for individuals who travel to high altitudes. In addition, ibuprofen was effective when taken six hours before ascent, in contrast to acetazolamide, whose recommendations include that it be started the day before travel to high altitude …
The authors say that taking more than 600 mg of ibuprofen might provide more robust prevention, but that the theoretical benefit of such a move would have to weighed against a possibly increased risk of gastrointestinal and kidney problems in people who may be dehydrated.
Written by Rupert Shepherd