Document Detail


Usefulness of fluoxetine hydrochloride for prevention of resistant upright tilt induced syncope.
MedLine Citation:
PMID:  7681197     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Recurrent vasovagally mediated episodes of hypotension and bradycardia are a common cause of recurrent syncope that can be identified by head-upright tilt table testing. Although the use of beta blockers, transdermal scopolamine, disopyramide, and fludrocortisone may be helpful in preventing further episodes, some patients are intolerant of or respond poorly to each of these agents. Following anecdotal observations, we investigated the utility of fluoxetine (a serotonin re-uptake antagonist) in preventing head-upright tilt induced hypotension/bradycardia in patients unresponsive to or intolerant of standard therapy. Sixteen patients (7 men and 9 women, mean age 42 +/- 21 years) with recurrent syncope and positive head-upright tilt studies (refractory to normal therapy) were placed on fluoxetine and restudied 5-6 weeks afterward. Three patients were intolerant of the medication. Of the 13 patients who underwent repeat tilt studies, seven patients (53% of the patients retested or 44% of the total group) were rendered tilt table negative, and, over a mean follow-up period of 19 +/- 9 months, have remained asymptomatic. We conclude that fluoxetine may be an effective therapy in patients with recurrent vasovagally mediated syncope refractory to other forms of therapy.
Authors:
B P Grubb; D A Wolfe; D Samoil; P Temesy-Armos; H Hahn; L Elliott
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  16     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  1993 Mar 
Date Detail:
Created Date:  1993-04-22     Completed Date:  1993-04-22     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  458-64     Citation Subset:  IM; S    
Affiliation:
Department of Medicine, Medical College of Ohio, Toledo 43699.
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MeSH Terms
Descriptor/Qualifier:
Adult
Bradycardia / complications*,  diagnosis,  prevention & control
Drug Tolerance
Female
Fluoxetine / therapeutic use*
Humans
Hypotension, Orthostatic / complications*,  diagnosis,  prevention & control
Male
Posture / physiology
Syncope / etiology,  prevention & control*
Chemical
Reg. No./Substance:
54910-89-3/Fluoxetine

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


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