From the Research
Gabapentin (Neurontin) is not recommended for treating Acute Mountain Sickness (AMS). The current evidence does not support its use for this condition, as clinical studies have not demonstrated consistent effectiveness in preventing or treating AMS symptoms 1.
Key Points
- The established first-line medication for AMS prevention and treatment is acetazolamide (Diamox), typically dosed at 125-250 mg twice daily, starting 24 hours before ascent and continuing for 48 hours at the higher altitude 2.
- Dexamethasone (4 mg every 6 hours) is an alternative, particularly for those who cannot tolerate acetazolamide.
- Gabapentin, while sometimes used off-label for neuropathic pain and seizures, does not address the underlying pathophysiology of AMS, which involves hypoxia-induced changes in cerebral blood flow and fluid balance 3.
- The most effective non-pharmacological approach remains gradual ascent (300-500 meters per day when above 3,000 meters) with adequate acclimatization time.
- If symptoms of AMS develop, the best immediate action is to stop ascending, rest, and descend if symptoms worsen 4.
Considerations
- Acetazolamide has been shown to be effective in reducing the incidence and severity of AMS symptoms, with a number needed to treat ranging from 8 to 3 among trials 2, 1.
- Sumatriptan and gabapentin have shown some benefit in individual trials, but require further study to confirm their effectiveness 1.
- Antioxidants, magnesium, and Ginkgo biloba have not been shown to be efficacious in preventing or treating AMS 1.