Document Detail


Efficacy of midodrine hydrochloride in neurocardiogenic syncope refractory to standard therapy.
MedLine Citation:
PMID:  9116967     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Some patients with neurocardiogenic syncope continue to have recurrent syncope or presyncope despite the use of currently available drug therapy. The purpose of this study was to determine whether midodrine hydrochloride, a selective adrenergic agonist, could be effective in patients resistant to, or intolerant of, currently used medications in the treatment of neurocardiogenic syncope. METHODS AND RESULTS: Eleven patients with a history of recurrent syncope or presyncope in whom hypotension with syncope or presyncope could be provoked during head-up tilt testing were included. There were 4 men and 7 women with a mean age (+/-SD) age of 34 +/- 13 years. In all patients, standard therapy with beta-adrenergic receptor blocking agents, ephedrine, theophylline, disopyramide, fludrocortisone, and sertraline hydrochloride, was either ineffective, poorly tolerated, or contraindicated. Midodrine was initially administered orally at a dose of 2.5 mg three times daily. After adjustment of dosage over 2 to 4 weeks, patients were followed-up clinically. Midodrine was discontinued in one patient because of side effects. Frequency of syncope or presyncope during the 3 months prior to starting treatment was compared during a mean follow-up of 17 +/- 4 weeks after starting treatment with midodrine. There was significant (P < 0.01) reduction in syncopal and presyncopal episodes on midodrine. Five patients had complete resolution of symptoms, while four patients had significant improvement. Symptoms did not improve in one patient. CONCLUSIONS: Midodrine hydrochloride can be effective in preventing recurrent symptoms in selected patients with neurocardiogenic syncope unresponsive to, or intolerant of, standard drug therapy.
Authors:
J Sra; C Maglio; M Biehl; A Dhala; Z Blanck; S Deshpande; M R Jazayeri; M Akhtar
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  8     ISSN:  1045-3873     ISO Abbreviation:  J. Cardiovasc. Electrophysiol.     Publication Date:  1997 Jan 
Date Detail:
Created Date:  1997-04-22     Completed Date:  1997-04-22     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  42-6     Citation Subset:  IM; S    
Affiliation:
Electrophysiology Laboratory, St. Luke's Medical Center, University of Wisconsin-Milwaukee, USA.
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MeSH Terms
Descriptor/Qualifier:
Administration, Oral
Adult
Drug Tolerance
Female
Humans
Male
Middle Aged
Midodrine / administration & dosage*
Sympathomimetics / administration & dosage*
Syncope, Vasovagal / drug therapy*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Sympathomimetics; 42794-76-3/Midodrine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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