A Cochrane review [Abstract] 2 included 11 studies with a total of 375 subjects. One trial found a greater proportion of participants with complete relief of acute mountain sickness (AMS)symptoms after 12 and 16 hours with dexamethasone compared with placebo (47.1% versus 0%, respectively; 35 participants). Likewise, when acetazolamide was compared with placebo, the effects on symptom severity was uncertain (standardized mean difference (SMD) −1.15, 95% CI −2.56 to 0.27; 2 studies, 25 participants; low‐quality evidence). One trial of dexamethasone in comparison with placebo in 35 participants found a reduction in symptom severity (difference on change in the AMS score: 3.7 units).
A topic in Clinical Evidence 1 summarizes the results of one RCT (n=35). After treatment for 12 hours at the altitude of 4559 meters (where symptoms began), dexamethasone improved mean symptom scores of acute mountain sickness (4.1 vs 0.4, 95% CI for difference 2.2 to 5.3) compared with placebo.
One RCT (n=12, with one person non-randomly assigned to placebo) found that acetazolamide reduced the number of people with symptoms after 24 hours (1/6 vs 6/6, p=0.015).
Comment: The quality of evidence was downgraded by sparse data.
Primary/Secondary Keywords