Use Acetazolamide in the Complex Therapy of Alzheimer's Disease.

Abstract

Impaired glymphatic clearance is one of the causes of Alzheimer's disease. Acetazolamide is a drug that affects the normalization of glymphatic clearance. We followed four women aged 65-70 years with a diagnosis of Alzheimer's disease in 2019-2021. They were treated in the unit according to Alzheimer's disease treatment standards. During periodic examination by an ophthalmologist, they were diagnosed with first-stage glaucoma (initial) - a blind spot interfering with normal peripheral vision and a deepening of the optic disc in the central zone were identified. For a glaucoma treatment, they were prescribed Acetazolamide 125 mg once a day in the morning for 7 days with weekly monitoring of intraocular pressure. They also received Asparkam, 1 tablet, 3 times a day during Acetazolamide administration to prevent a deficiency of potassium ions in the body. On days 12-14 after normalization intraocular pressure, Acetazolamide administration was discontinued. To monitor the dynamics of cognitive impairment, patients on the unit underwent Trail Making Test Parts A & B paper-pencil versions every month. Before glaucoma treatment, the patients' Trail Making Test Parts A speeds were 84, 87, 90, and 92 seconds. The speed of Part B was 270, 300, 293, and 305 seconds. After two weeks of glaucoma treatment, patients again completed the Trail Making Test Parts A & B paper-pencil versions. The patients' speeds for Part A were 60, 68, 63, and 70 seconds. The speeds in Part B were 180, 190, 217, and 194 seconds. Administration of Acetazolamide has a positive effect on patients with cognitive deficits and can be successfully used as part of the complex therapy of Alzheimer's disease.