May 23, 2003 MGH study finds acetaminophen as effective as ibuprofen for high-altitude headache

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May 23, 2003

MGH study finds acetaminophen as effective as ibuprofen for high-altitude headache

In a study conducted near the Mt. Everest base camp in Nepal, an MGH resident and his colleagues have found that acetaminophen is as effective as ibuprofen in treating high-altitude headaches. Because it has fewer side effects than medications like ibuprofen, acetaminophen may be the best choice for those who experience headaches when they travel to high altitudes. The report appears in the May Journal of Emergency Medicine.

"If you have two equally effective drugs for a condition, it makes sense to use the one with the fewest probable side effects," says study leader N. Stuart Harris, MD, who currently is completing his emergency medicine residency in the MGH/BWH combined program. Harris spent three months in Nepal in the spring of 1999, investigating whether acetaminophen might be as effective as ibuprofen, which previous research had shown was useful for high-altitude headaches.

A severe, throbbing headache is the primary symptom of acute mountain sickness, which also can include nausea, sleeplessness, loss of appetite and fatigue. Caused by reduced levels of oxygen, mountain sickness can lead to serious, even fatal complications characterized by edema — a buildup of fluid — in the lungs or brain. The researchers, including Stephen Thomas, MD, of MGH Emergency Medicine, wanted to investigate acetaminophen's potential role in treating high-altitude headaches because the medication does not cause gastrointestinal problems, which ibuprofen and other nonsteroidal anti-inflammatory drugs (NSAIDS) sometimes can. A previous study also showed that patients with high-altitude pulmonary edema were more likely to have taken NSAIDS.

Harris surveyed hikers arriving at a Nepal camp a day's hike below the established Everest base camp. He enrolled 74 hikers with symptoms of high-altitude headaches. Participants received identical capsules containing either acetaminophen or ibuprofen and subsequently completed a survey for headache symptoms and severity. Both groups reported similar levels of pain relief during the two-hour study period. Although none of the participants reported symptoms of edema, Harris notes that animal studies also suggest a way that NSAIDS could contribute to that dangerous condition in the lungs, further suggesting that acetaminophen may be the safest choice.

Harris, left, in Nepal

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