Antipsychotic and Prophylactic Effects of Acetazolamide (Diamox) on Atypical Psychosis

Abstract

We investigated the antipsychotic and prophylactic effects of acetazolamide (Diamox) on atypical psychosis. Acetazolamide was given to 30 patients: Type I, puberal periodic psychosis, a psychosis whose onset occurs during the period of puberty and which appears repetitively with psychosis‐like condition at about the same interval as the menstrual cycle (6 cases); Type II, a) presenile atypical psychosis which initially appears in patients in their 20s or 30s accompanied by manic‐depressive cycles and shows acute confusional and dreamy states in the presenile period, incurable cases (7), b) atypical psychosis, in the narrow sense, cases which show acute hallucination, delusion, confusional and dreamy states accompanied by affective symptoms (8 cases); Type III, repetitively the atypical manic and depressive states, and atypical manic‐depressive psychosis, and transient changes in consciousness, refractory cases (2); Type IV, atypical schizophrenia, which is considered to be schizophrenia but shows the abnormalities in electroencephalogram and emotional disorders (7 cases). Among these cases, some extent of the therapeutic effects of acetazolamide (500–1,000 mg/day) was obtained in about 70%. The high therapeutic effects were particularly observed in Types I, II and III. It was less effective against atypical schizophrenia. Acetazolamide showed the effectiveness in 10 cases out of 13 cases to which lithium carbonate and carbamazepine were ineffective. The high therapeutic effects of acetazolamide were shown in the cases whose symptoms were aggravated at the interval of the menstrual cycle. No correlation was observed between the electroencephalographic abnormalities and the therapeutic effects. In addition, the prophylactic effects of acetazolamide on the periodic crisis were observed in 9 cases. From these results, acetazolamide was considered to have the antipsychotic and prophylactic effects on atypical psychosis. Since side effects due to acetazolamide were rarely observed, the present drug was considered to have a high safety margin.

Psychoses in Epilepsy: A Review of Japanese Studies

“…Inoue et al (88) reported that acetazolamide had therapeutic and prophylactic effects on AEP. Using CT evaluation, Hayashi et al (89) reported that while typical schizophrenia had large interhemispheric fissures and lateral and third ventricles, AEP showed greater sylvian fissures, especially right-sided enlargement.…”

Oestrogen withdrawal associated psychoses

“…The association of the onset of the recurrent psychosis and premenstruum was repeated and unambiguous in 14 cases only (11, 22–31), and these cases were formerly included in the oestrogen withdrawal hypothesis (11). These 14 cases were categorized in the group of EWAP and the remaining cases, where the association was more doubtful, were categorized to ECAP (32–56) (Table 2).…”

Characterization of Carbonic Anhydrase In Vivo Using Magnetic Resonance Spectroscopy

“…Historically, CAI acetazolamide was marketed as a diuretic drug and concurrently its anticonvulsant property was discovered [93]. In addition, use of CAI in the treatment of several psychiatric disorders has also been reported.…”