Q: I have had complex partial seizures for approx. 25 yrs. I am taking Tegretol, Dilantin, Phenobarbital and Diamox. After many combinations and different medications the addition of Diamox is the one factor that has given control. It is not used often for seizure control but it seems to work for me. What, if any, are the side effects of long-term use.?
Thank you for your time
A: Acetazolamide (Diamox) is a weak diuretic that works by inhibiting the enzyme, carbonic anhydrase. This enzyme produces bicarbonate in the brain and in the urine from water and carbon dioxide. When acetazolamide inhibits this enzyme, it makes your blood chemistry more acidic. The main side effect is that it can foster the formation of kidney stones with long-term use, especially in persons who are prone (have a history or family history) to kidney stones. Drinking plenty of fluids may help prevent stones. It may also cause drowsiness, and tingling of the hands and feet.
Why it works against seizures is unclear. It may be very effective for some people, but most people tend to "build up a resistance" to it, which is why it is not used more commonly.