Dear Dr. Can Dizziness , Drowsiness , And Lightheadedness Be

Brief Answer:
Short answer is YES

Detailed Answer:
Thank you for your question.

The likely name of the condition for which you are taking this medication is either IDIOPATHIC INTRACRANIAL HYPERTENSION, abbreviated (IIH) with an older more antiquated term of PSEUDOTUMOR CEREBRI (PC) as a possible alternative. The abbreviation ICP simply stands for INTRACRANIAL PRESSURE which is a term we use when discussing the actual fluid pressure of cerebrospinal fluid (CSF) within the cranial vault. However, "confirmed ICP" does not indicate whether it is HIGH, LOW, or NORMAL. See the difference? Everyone actually has ICP...otherwise, we'd all be able to try out for those walking zombie movies....so in order to specify the disorder properly you will want to ask your doctor whether you've been diagnosed with PC or IIH. Then, you'll be talking the medical lingo in a more direct fashion.

Now, the short answer to your question is: YES. All of the symptoms you've described are possible side effects from taking this medications. BUT, be aware that they also may me the EXPECTED REACTIONS that your body can be experiencing in the initial phases of taking the drug IF IT IS REALLY WORKING to drive pressures in the head down. And here's why.

If your ICP's have been elevated chronically for a long time and your body has "acclimated" to that state of pressures, what could happen if those pressures were to SUDDENLY be LOWERED or even NORMALIZED by using a medication or even by surgical means? What do you think could happen?

Well, one of 4 things could happen.

Scenario #1. The person may not feel any change of a negative nature and simply realize after a while (maybe a few days or few weeks) that things such as headaches, double or blurry vision, and any of the other symptoms you were having PRIOR to taking the diamox have stabilized or with a little luck DISAPPEARED. This is what EVERYONE HOPES FOR right out of the gate, doctors, patients, nurses, even the kid on the street holding the red balloon at the carnival...EVERYONE hopes for this scenario. This is what makes medicine so fun when things go exactly as planned! HAHA! But wait...REAL LIFE...things don't always go as planned...so READ ON good sir.

Scenario #2. There may be a reaction of the BODY against the fact that SUDDENLY PRESSURES are changing (even though that's what we want) by virtue of taking this medication and so the body gives you the message (albeit in an uncomfortable manner) that it doesn't particularly like the fact you're changing the internal environment to which it has been used to for so long and it will need to stabilize at a new equilibrium point (symptoms you mention)....so you feel the discomfort although it is also possible that your PRIMARY symptoms of the severe headaches, blurry vision, nausea/vomiting, visual blankouts, etc. may be gone. In other words, your symptoms may be a reflection of the body RECALIBRATING itself to the newly imposed requirement of lower pressures.

Scenario #3. The medication has worked TOO WELL and exactly for the fact that it is not just recalibrating BUT perhaps going too far the OTHER direction from SUPER HIGH to SUPER LOW (what we would call CSF HYPOTENSION) your ICP has gone past the good point...and hence your symptoms. In this scenario you actually could have symptoms of headaches, pounding in the head, fuzziness in thinking which all become worse upon standing but better when lying down, etc. We could hypothesize a state of cerebrospinal fluid (CSF) HYPOTENSION caused by the medication...NOT SIDE EFFECTS....JUST the medication doing its job TOO WELL....could be due to too high a dose or the person's system is very sensitive to the pharmacological action of this carbonic anhydrase inhibitor (its mechanism of action).

Scenario #4. SIDE EFFECTS caused by the drug. This is where the medication itself does not agree with your body in the least nor is it being helpful in the least and all the primary symptoms for which you've received the diagnosis of PC or IIH are still there AND now on top of that the medication doesn't agree. This would be the scenario of classical side effects of a drug that I refer to as INTOLERABLE for a patient and needs to be evaluated by the prescribing physician to get things back on the right track.

So, in the last scenario your doctor would definitely be tempted to CHANGE the medication straight away....Make sense? It doesn't help with any of your symptoms and it's not being very nice to you by making you feel crappy. If it were my call I might consider something completely different such as topiramate or zonisamide.

In the other scenarios I might still stay with the medication but I would adjust dosages or put the patient on a less AGGRESSIVE regimen that would lessen the DROP in ICP or something along those lines....Make sense? Or I might decide that the medication is actually doing its job and that your body needs a little more adjustment time so I may ask you to continue taking the drug to see if some of those bothersome symptoms might resolve with time....make keep track of things in a journal so you can gauge if in fact symptoms are getting better, worse, or not changing over time.

And so now, you have a bit more information to work with alongside your doctor. Please do not go changing doses of your medication or stopping the medication without consulting with your prescribing physician since the diagnosis of IIH or PC is important and your pressures intracranially must be regulated in order to reduce your risks for serious complications. The good news is there are options as how to proceed from here so call your doctor and see what they want to do. You can even try out some of the abbreviations you've learned unless of course, you're going to talk to your doctor in a different language in which case those abbreviations won't help very much! LOL!

And so kind person, if I've provided useful or helpful information to your question could you do me the utmost of favors by CLOSING THE QUERY along with a few positive words of feedback and maybe even a 5-star rating if you feel it is deserving? I am definitely interested in getting updated information on your condition if you'd care to drop me a line at www.bit.ly/drdariushsaghafi and let me know how things turned out.

You can always reach me at the above address for this and other questions. I wish you the best with everything and hope our discussion has aided in your understanding of a few concepts related to your concerns.

Regards.


This query required 42 minutes of professional time to research, assimilate, and file a response.

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Brief Answer:
Short answer is YES

Detailed Answer:
Thank you for your question.

The likely name of the condition for which you are taking this medication is either IDIOPATHIC INTRACRANIAL HYPERTENSION, abbreviated (IIH) with an older more antiquated term of PSEUDOTUMOR CEREBRI (PC) as a possible alternative. The abbreviation ICP simply stands for INTRACRANIAL PRESSURE which is a term we use when discussing the actual fluid pressure of cerebrospinal fluid (CSF) within the cranial vault. However, "confirmed ICP" does not indicate whether it is HIGH, LOW, or NORMAL. See the difference? Everyone actually has ICP...otherwise, we'd all be able to try out for those walking zombie movies....so in order to specify the disorder properly you will want to ask your doctor whether you've been diagnosed with PC or IIH. Then, you'll be talking the medical lingo in a more direct fashion.

Now, the short answer to your question is: YES. All of the symptoms you've described are possible side effects from taking this medications. BUT, be aware that they also may me the EXPECTED REACTIONS that your body can be experiencing in the initial phases of taking the drug IF IT IS REALLY WORKING to drive pressures in the head down. And here's why.

If your ICP's have been elevated chronically for a long time and your body has "acclimated" to that state of pressures, what could happen if those pressures were to SUDDENLY be LOWERED or even NORMALIZED by using a medication or even by surgical means? What do you think could happen?

Well, one of 4 things could happen.

Scenario #1. The person may not feel any change of a negative nature and simply realize after a while (maybe a few days or few weeks) that things such as headaches, double or blurry vision, and any of the other symptoms you were having PRIOR to taking the diamox have stabilized or with a little luck DISAPPEARED. This is what EVERYONE HOPES FOR right out of the gate, doctors, patients, nurses, even the kid on the street holding the red balloon at the carnival...EVERYONE hopes for this scenario. This is what makes medicine so fun when things go exactly as planned! HAHA! But wait...REAL LIFE...things don't always go as planned...so READ ON good sir.

Scenario #2. There may be a reaction of the BODY against the fact that SUDDENLY PRESSURES are changing (even though that's what we want) by virtue of taking this medication and so the body gives you the message (albeit in an uncomfortable manner) that it doesn't particularly like the fact you're changing the internal environment to which it has been used to for so long and it will need to stabilize at a new equilibrium point (symptoms you mention)....so you feel the discomfort although it is also possible that your PRIMARY symptoms of the severe headaches, blurry vision, nausea/vomiting, visual blankouts, etc. may be gone. In other words, your symptoms may be a reflection of the body RECALIBRATING itself to the newly imposed requirement of lower pressures.

Scenario #3. The medication has worked TOO WELL and exactly for the fact that it is not just recalibrating BUT perhaps going too far the OTHER direction from SUPER HIGH to SUPER LOW (what we would call CSF HYPOTENSION) your ICP has gone past the good point...and hence your symptoms. In this scenario you actually could have symptoms of headaches, pounding in the head, fuzziness in thinking which all become worse upon standing but better when lying down, etc. We could hypothesize a state of cerebrospinal fluid (CSF) HYPOTENSION caused by the medication...NOT SIDE EFFECTS....JUST the medication doing its job TOO WELL....could be due to too high a dose or the person's system is very sensitive to the pharmacological action of this carbonic anhydrase inhibitor (its mechanism of action).

Scenario #4. SIDE EFFECTS caused by the drug. This is where the medication itself does not agree with your body in the least nor is it being helpful in the least and all the primary symptoms for which you've received the diagnosis of PC or IIH are still there AND now on top of that the medication doesn't agree. This would be the scenario of classical side effects of a drug that I refer to as INTOLERABLE for a patient and needs to be evaluated by the prescribing physician to get things back on the right track.

So, in the last scenario your doctor would definitely be tempted to CHANGE the medication straight away....Make sense? It doesn't help with any of your symptoms and it's not being very nice to you by making you feel crappy. If it were my call I might consider something completely different such as topiramate or zonisamide.

In the other scenarios I might still stay with the medication but I would adjust dosages or put the patient on a less AGGRESSIVE regimen that would lessen the DROP in ICP or something along those lines....Make sense? Or I might decide that the medication is actually doing its job and that your body needs a little more adjustment time so I may ask you to continue taking the drug to see if some of those bothersome symptoms might resolve with time....make keep track of things in a journal so you can gauge if in fact symptoms are getting better, worse, or not changing over time.

And so now, you have a bit more information to work with alongside your doctor. Please do not go changing doses of your medication or stopping the medication without consulting with your prescribing physician since the diagnosis of IIH or PC is important and your pressures intracranially must be regulated in order to reduce your risks for serious complications. The good news is there are options as how to proceed from here so call your doctor and see what they want to do. You can even try out some of the abbreviations you've learned unless of course, you're going to talk to your doctor in a different language in which case those abbreviations won't help very much! LOL!

And so kind person, if I've provided useful or helpful information to your question could you do me the utmost of favors by CLOSING THE QUERY along with a few positive words of feedback and maybe even a 5-star rating if you feel it is deserving? I am definitely interested in getting updated information on your condition if you'd care to drop me a line at www.bit.ly/drdariushsaghafi and let me know how things turned out.

You can always reach me at the above address for this and other questions. I wish you the best with everything and hope our discussion has aided in your understanding of a few concepts related to your concerns.

Regards.


This query required 42 minutes of professional time to research, assimilate, and file a response.

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