[Off-label use of acetazolamide in a patient with familial hemiplegic migraine and concomitant psychotic episodes].
A 42-year-old patient with cognitive deficits due to childhood meningitis suffered from recurrent episodes of familial hemiplegic migraine. Additionally, he developed concomitant psychotic episodes requiring subsequent in-patient psychiatric treatment. Following combined neurological and psychiatric treatment he always recovered from the episodes within a few weeks time. Prophylactic treatment of migraine using topiramate and acetazolamide (off-label) prevented attacks for several months. When off-label compensation was refused and, as a consequence, the drug discontinued, hemiplegia relapsed within a few days. Hence, acetazolamide was prescribed again and the family paid for the medication. Since that time, the patient did not show severe attacks for at least 8 months apart from a transient attack induced by acute flu-like illness.
Koch
Horst J
HJ
Klinik für Psychiatrie und Psychotherapie, HELIOS Klinikum Aue. horst.koch@helios-kliniken.de
Sykora
André
A
Hausn
Patrick
P
D000086:Acetazolamide / Q000191:economics / Q000627:therapeutic use*; D000328:Adult; D000927:Anticonvulsants / Q000191:economics / Q000627:therapeutic use*; D002257:Carbonic Anhydrase Inhibitors / Q000191:economics / Q000627:therapeutic use*; D015897:Comorbidity; D016527:Drug Costs / Q000706:statistics & numerical data; D004359:Drug Therapy, Combination; D005382:Financing, Personal / Q000191:economics; D005632:Fructose / Q000031:analogs & derivatives / Q000627:therapeutic use; D005858:Germany; D006801:Humans; D007356:Insurance, Pharmaceutical Services / Q000191:economics; D008607:Intellectual Disability / Q000188:drug therapy / Q000523:psychology; D008297:Male; D020325:Migraine with Aura / Q000188:drug therapy* / Q000523:psychology; D009313:National Health Programs / Q000191:economics; D056687:Off-Label Use / Q000191:economics; D011618:Psychotic Disorders / Q000188:drug therapy* / Q000235:genetics / Q000523:psychology; D000077236:Topiramate; D016896:Treatment Outcome
D000927:Anticonvulsants; D002257:Carbonic Anhydrase Inhibitors; D000077236:Topiramate; D005632:Fructose; D000086:Acetazolamide