Medical Care for OI
• Overview
• Common Meds
• Other Factors to Consider
• Full List By What They Do
• Hyperadrenergic POTS
• References
Medications - References by Drug Type
Fludrocortisone
- Axelrod FB, Goldberg JD, Rolnitzky L, et al. Fludrocortisone in patients with familial dysautonomia—assessing effect on clinical parameters and gene expression. Clin Auton Res 2005; 15:284–291.
- Chobanian AV, Volicer L, Tifft CP, Gavras H, Liang CS, Faxon D. Mineralocorticoid-induced hypertension in patients with orthostatic hypotension. N Engl J Med 1979; 301:68–73.
- Hussain RM, McIntosh SJ, Lawson J, Kenny RA. Fludrocortisonein the trea tment of hypotensive disorders in the elderly. Heart 1996; 76:507–509.
- van Lieshout JJ, Ten Harkel AD, Wieling W. Fludrocortisone and sleeping in the head-up position limit the postural decrease in cardiac output in autonomic failure. Clin Auton Res 2000; 10:35–42.
Beta-Blockers
- Mahanonda N, et al. Randomized double-blind, placebo-controlled trial of oral atenolol in patients with unexplained syncope and positive upright tilt table test results. Am Heart J 1995;130:1250-3.
- Raj SR, Black BK, Biaggoni I,Paranjape SY, Ramirez M, Dupont WD, Robertson D. Propranolol decreases tachycardia and improves symptoms in the postural tachycardia syndrome: less is more. Circulation 2009;120:725-34.
Midodrine
- Gilden JL. Midodrine in neurogenic orthostatic hypotension. A new treatment. Int Angiology. 1993;12:125–131.
- Jancovic J, Gilden JL, Hiner BC, et al. Neurogenic orthostatic hypotension: a double-blind placebo-controlled study with midodrine.Am J Med. 1993;95:38–48. [[103142. Gilden JL. Midodrine in neurogenic orthostatic hypotension. A new treatment. Int Angiology. 1993;12:125–131.
- Ward CR, et al. Midodrine: a role in the management of neurocardiogenic syncope. Heart 1998; 79:45-9.
- Qingyou Z, et al. The efficacy of midodrine in the treatment of children with vasovagal syncope. J Pediatr 2006;149:777-80.
Pyridostigmine
- Raj SR, Black BK, Biaggioni I, Harris PA, Robertson D. Acetylcholinesterase inhibition improves tachycardia in postural tachycardia syndrome.Circulation. 2005;111:2734–40. Abstract.
- Singer W, Sandroni P, Opfer-Gehrking TL, Suarez GA, Klein CM, Hines S, O'Brien PC, Slezak J, Low PA. Arch Neurol. 2006 Apr; 63(4):513-8.
- Singer W, et al. Acetylcholinesterase inhibition in patients with orthostatic intolerance. J Clin Neurophysiol 2006;23:477-82.
- Filler G, et al. Pharmacokinetics of pyridostigmine in a child with postural tachycardia syndrome. Pediatrics 2006;118:e1563-8.
SSRIs/SNRIs
- Di Girolamo E, et al. Effects of paroxetine hydrochloride, a selective serotonin reuptake inhibitor, on refractory vaso-vagal syncope: a randomized, double-blind, placebo-controlled study. JACC 1999;33: 1227-30.
Stimulants
- Susmano A, Volgman AS, Buckingham TA. Beneficial effects of dextro-amphetamine in the treatment of vasodepressor syncope. PACE 1993;16:1235-9.
- Grubb BP, Kosinski D, Mouhaffel A, Pothoulakis A. Use of methylphenidate in the treatment of refractory neurocardiogenic syncope. PACE 1996;19:836-40.
- Olson LG, Ambrogetti A, Sutherland DC. A pilot randomized controlled trial of dexamphetamine in patients with chronic fatigue syndrome. Psychosomatics 2003;44:38-43.
- Blockmans D, Persoons P, van Houdenhove B, Bobbaers H. Does methylphenidate reduce the symptoms of chronic fatigue syndrome? Am J Med 2006;119:167.e23-167.e30.
Other
- Hoeldtke RD, Streeten DH. Treatment of orthostatic hypotension with erythropoietin. N Engl J Med 1993;329:611-5. Perera R, Isola L, Kaufmann H. Effect of recombinant erythropoietin on anemia and orthostatic hypotension in primary autonomic failure. Clin Auton Res 1995; 5:211-3.
- Biaggioni I, Robertson D, Krantz S, Jones M, Haile V. The anemia of primary autonomic failure and its reversal with recombinant erythropoietin. Ann Intern Med 1994;121:181-6.
- Robertson D, et al. Clonidine raises blood pressure in severe idiopathic orthostatic hypotension. Am J Med 1983;74:193-200.
- Di Girolamo E, et al. Effects of paroxetine hydrochloride, a selective serotonin reuptake inhibitor, on refractory vaso-vagal syncope: a randomized, double-blind, placebo-controlled study. JACC 1999;33: 1227-30.
- Boehm KE, et al. Neurocardiogenic syncope: response to hormonal therapy. Pediatrics 1997;99:623-5.
- Zeng C, et al. Randomized, double-blind, placebo-controlled trial of oral enalapril in patients with neurally mediated syncope. Am Heart J 1998;136:852-8.
Author: Kay E. Jewell, MD
Page Last Updated: August 11, 2012