Evidence map›Paper›PMID 29898611›Full record

ArticleCephalalgia : an international journal of headache2019

Topiramate is more effective than acetazolamide at lowering intracranial pressure.

William J Scotton, Hannah F Botfield, Connar Sj Westgate, James L Mitchell, Andreas Yiangou, Maria S Uldall, Rigmor H Jensen, Alex J Sinclair

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Cephalalgia : an international journal of headache, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
45citing papers in PubMed, 3 pooled it
5.9field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

45 citing papers in PubMed, 3 syntheses or guidelines pooled it, 88 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
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  7. Review
  8. Topiramate Versus Acetazolamide for Idiopathic Intracranial Hypertension. A Real-World Data-Based Multicenter Retrospective Study.Indian journal of pharmaceutical education : official publication of Association of Pharmaceutical Teachers of India · 2026
    Article
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  12. Reducing the global burden of cerebral venous thrombosis: An international research agenda.International journal of stroke : official journal of the International Stroke Society · 2024
    Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 2 countries.

William J Scotton1 Metabolic Neurology, Metabolic Neurology, Institute of Metabolism and Systems Research, University of Birmingham, Edgbaston, Birmingham, UK.
Hannah F Botfield4 Institute of Inflammation and Ageing, University of Birmingham, Edgbaston, Birmingham, UK.ORCID 0000-0003-4564-0282
Connar Sj Westgate1 Metabolic Neurology, Metabolic Neurology, Institute of Metabolism and Systems Research, University of Birmingham, Edgbaston, Birmingham, UK.ORCID 0000-0001-5066-8306
James L Mitchell1 Metabolic Neurology, Metabolic Neurology, Institute of Metabolism and Systems Research, University of Birmingham, Edgbaston, Birmingham, UK.
Andreas Yiangou1 Metabolic Neurology, Metabolic Neurology, Institute of Metabolism and Systems Research, University of Birmingham, Edgbaston, Birmingham, UK.
Maria S Uldall5 Danish Headache Center, Clinic of Neurology, Rigshospitalet-Glostrup, University of Copenhagen, Glostrup, Denmark.
Rigmor H Jensen5 Danish Headache Center, Clinic of Neurology, Rigshospitalet-Glostrup, University of Copenhagen, Glostrup, Denmark.
Alex J Sinclair1 Metabolic Neurology, Metabolic Neurology, Institute of Metabolism and Systems Research, University of Birmingham, Edgbaston, Birmingham, UK.
University Hospitals Birmingham NHS Foundation Trust · GBUniversity of Birmingham · GBUniversity of Copenhagen · DK

Funding

Department of Health NIHR-CS-011-028Medical Research Council MR/K015184/1Wellcome Trust
6 · The paper itself

Abstract

backgroundThe management of idiopathic intracranial hypertension focuses on reducing intracranial pressure to preserve vision and reduce headaches. There is sparse evidence to support the use of some of the drugs commonly used to manage idiopathic intracranial hypertension, therefore we propose to evaluate the efficacy of these drugs at lowering intracranial pressure in healthy rats.

methodsWe measured intracranial pressure in female rats before and after subcutaneous administration of acetazolamide, topiramate, furosemide, amiloride and octreotide at clinical doses (equivalent to a single human dose) and high doses (equivalent to a human daily dose). In addition, we measured intracranial pressure after oral administration of acetazolamide and topiramate.

resultsAt clinical and high doses, subcutaneous administration of topiramate lowered intracranial pressure by 32% ( p = 0.0009) and 21% ( p = 0.015) respectively. There was no significant reduction in intracranial pressure noted with acetazolamide, furosemide, amiloride or octreotide at any dose. Oral administration of topiramate significantly lowered intracranial pressure by 22% ( p = 0.018), compared to 5% reduction with acetazolamide ( p = >0.999).

conclusionOur in vivo studies demonstrated that both subcutaneous and oral administration of topiramate significantly lowers intracranial pressure. Other drugs tested, including acetazolamide, did not significantly reduce intracranial pressure. Future clinical trials evaluating the efficacy and side effects of topiramate in idiopathic intracranial hypertension patients would be of interest.

Indexed as

AcetazolamideAmilorideAnimalsAnticonvulsantsDiureticsFemaleFurosemideIntracranial PressureOctreotideRatsRats, Sprague-DawleyTopiramateAcetazolamideAmilorideAnticonvulsantsDiureticsFurosemideOctreotideTopiramateCerebrospinal fluidchoroid plexusheadacheidiopathic intracranial hypertension

Identifiers

PMID29898611
PMCPMC6376637
OpenAlexW2808303746

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.