Effect upon serum insulin, glucose and potassium concentrations of acetazolamide during attacks of familial periodic hypokalemic paralysis.

In four patients with periodic hypokalemic paralysis paralytic attacks were induced in the untreated state and later, after the patients had been treated with acetazolamide. There was a distinct, clinically favourable effect of acetazolamide upon the length as well as the severity of paralysis. The maximum fall in serum potassium was less marked during acetazolamide therapy. After treatment all four patients showed significantly reduced serum levels of glucose and insulin during induced attacks of paralysis as compared with the levels obtained during paretic attacks in the untreated state. These findings indicate that the prophylactic effect of this drug does not relate merely to metabolic acidosis. The hypothesis is advanced that the lower serum insulin and glucose levels might represent reduced absorption which would amount to an indirect prophylactic action.