Sumatriptan for prevention of acute mountain sickness: randomized clinical trial

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Abstract
Objective: To determine the impact of sumatriptan prophylaxis on acute mountain sickness (AMS) and altitude headache development within 24 hours of ascent, we designed a double‐blind, randomized, clinical trial.Methods: A prospective, double‐blind, randomized, placebo‐controlled trial was conducted in Tochal Mountain Hotel at an altitude of 3,500 meters above sea level during October 2006 to November 2006. A total of 102 Iranian adults were assigned to receive either sumatriptan succinate (50mg) or placebo within 1 hour of ascent. AMS incidence was measured by Lake Louise AMS score ≥ 3 with headache and one other symptom. Secondary outcome measures included severity of syndrome (Lake Louise scores ≥ 5), incidence of headache, and severity of headache.Results: Based on intention‐to‐treat analysis, AMS was more prevalent in placebo group (n = 23 [45.1%]) than sumatriptan group (n = 12 [23.5%]; p = 0.02). Headache also had a greater rate for placebo users (placebo vs sumatriptan group: 29 [56.9%] vs 17 [33.3%]; p = 0.02). No association was detected between sumatriptan prophylaxis and AMS or altitude headache severity.Discussion: Sumatriptan prophylaxis is effective to prevent AMS development. Furthermore, our findings confirm cerebral vasodilative and edematous mechanisms of AMS progression, whereas sumatriptan is a selective 5‐hydroxytryptamine1 receptor subtype agonist and a selective cerebral vasoconstrictor as a result (http://www.controlled‐trials.com/ISRCTN87201238/). Ann Neurol 2007