Cognitive Effects of Dexamethasone at High Altitude☆

Lafleur, John; Giron, Miguel; DeMarco, M.; Kennedy, Robert S.; BeLue, Rhonda; Shields, Christopher

doi:10.1580/1080-6032(2003)014[0020:ceodah]2.0.co;2

Cited by 10 publications

(3 citation statements)

References 9 publications

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“…Comparing Dexamethasone with Acetazolamide or placebo, the use of Dexamethasone significantly reduced the incidence of AMS and the severity of symptoms, without affecting physical or mental aspects (p<0.05) (Ellsworth et al,1987;Ellsworth et al,1991). A study showed a decrease of cognitive deficits in asymptomatc subjects caused by subclinical cerebral oedema (Lafleur et al,2003).…”

Section: Glucocorticosteroidsmentioning

confidence: 99%

Drug Use and Misuse in the Mountains: A UIAA MedCom Consensus Guide for Medical Professionals

Donegani

Paal

Küpper

et al. 2016

High Altitude Medicine & Biology

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If using drugs not regulated by the World Anti-Doping Agency (WADA), individuals have to determine their own personal standards for enjoyment, challenge, acceptable risk, and ethics. No system of drug testing could ever, or should ever, be policed for recreational climbers. Sponsored climbers or those who climb for status need to carefully consider both the medical and ethical implications if using drugs to aid performance. In some countries (e.g., Switzerland and Germany), administrative systems for mountaineering or medication control dictate a specific stance, but for most recreational mountaineers, any rules would be unenforceable and have to be a personal decision, but should take into account the current best evidence for risk, benefit, and sporting ethics.

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Section: Glucocorticosteroidsmentioning

confidence: 99%

Drug Use and Misuse in the Mountains: A UIAA MedCom Consensus Guide for Medical Professionals

Donegani

Paal

Küpper

et al. 2016

High Altitude Medicine & Biology

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show abstract

“…Unlike acetazolamide, which prevents symptoms of AMS by assisting in pre-acclimatization, dexamethasone decreases cerebral edema by preserving endothelial integrity and preventing cerebral vascular leaking. 18,19 These properties of dexamethasone have led to interest in clinical trials for HAI prophylaxis. In addition, the antiemetic and mood-enhancing effects of dexamethasone could also explain the effectiveness of dexamethasone for HAI prevention.…”

Section: Dexamethasonementioning

confidence: 99%

Pharmacotherapy of High-Altitude Illness

Spooner

Olin

DeBellis

2007

American Journal of Lifestyle Medicine

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High-altitude illness (HAI) encompasses an array of conditions that may occur in individuals who travel to high elevations, including acute mountain sickness, high-altitude cerebral edema, and high-altitude pulmonary edema. Individuals with a history of HAI are predisposed to developing HAI; however, other risk factors are not well defined. The primary method of preventing HAI is acclimatization through gradual ascent to high altitude. In addition, many studies have assessed the use of pharmacologic prophylaxis. The most studied and widely recommended prophylactic agent is acetazolamide; additional agents that have been considered include dexamethasone, Gingko biloba, antioxidant vitamins, nifedipine, aspirin, and salmeterol. The treatment of choice for all forms of HAI is descent to lower altitude. The use of additional treatments, including supplemental oxygen, varies depending on the severity of the clinical presentation. Acetazolamide and dexamethasone have been studied as adjunctive treatments for acute mountain sickness, while nitric oxide and nifedipine have been evaluated for the treatment of high-altitude pulmonary edema. Data with analgesics and phosphodiesterase-5 inhibitors, while limited, are promising. This review will present the evidence supporting the use of pharmacotherapy for prevention and treatment of HAI.

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“…Acetazolamide has been shown to enhance exercise and cerebral oxygenation at altitude. 6,7 Dexamethasone improves cognitive performance 8,9 and exercise capacity 10,11 at altitude. That is strong evidence that these are performance-enhancing drugs.…”

mentioning

confidence: 99%

Medical and Sporting Ethics of High Altitude Mountaineering: The Use of Drugs and Supplemental Oxygen

Wagner

2012

Wilderness & Environmental Medicine

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Cognitive Effects of Dexamethasone at High Altitude☆

Abstract: These data show a trend toward decreased cognitive deficits in subjects pretreated with dexamethasone. One possibility for this trend is that cognitive deficits in otherwise asymptomatic subjects exposed to high altitude are caused by subclinical cerebral edema.

Cited by 10 publications

References 9 publications

Drug Use and Misuse in the Mountains: A UIAA MedCom Consensus Guide for Medical Professionals

Drug Use and Misuse in the Mountains: A UIAA MedCom Consensus Guide for Medical Professionals

Pharmacotherapy of High-Altitude Illness

Medical and Sporting Ethics of High Altitude Mountaineering: The Use of Drugs and Supplemental Oxygen

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