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Subsection: Medications
    •  Overview
    •  Common Meds
    •  Other Factors to Consider
    •  Full List By What They Do
   •  Hyperadrenergic POTS
   •  References

Medications - References by Drug Type

Fludrocortisone

  1. 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.
  2. 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.
  3. Hussain RM, McIntosh SJ, Lawson J, Kenny RA. Fludrocortisonein the trea tment of hypotensive disorders in the elderly. Heart 1996; 76:507–509.
  4. 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

  1. 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.
  2. 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

  1. Gilden JL. Midodrine in neurogenic orthostatic hypotension. A new treatment. Int Angiology. 1993;12:125–131.
  2. 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.
  3. Ward CR, et al. Midodrine: a role in the management of neurocardiogenic syncope. Heart 1998; 79:45-9.
  4. Qingyou Z, et al. The efficacy of midodrine in the treatment of children with vasovagal syncope. J Pediatr 2006;149:777-80.

Pyridostigmine

  1. Raj SR, Black BK, Biaggioni I, Harris PA, Robertson D. Acetylcholinesterase inhibition improves tachycardia in postural tachycardia syndrome.Circulation. 2005;111:2734–40.  Abstract.
  2. 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.
  3. Singer W, et al. Acetylcholinesterase inhibition in patients with orthostatic intolerance. J Clin Neurophysiol 2006;23:477-82.
  4. Filler G, et al. Pharmacokinetics of pyridostigmine in a child with postural tachycardia syndrome. Pediatrics 2006;118:e1563-8.
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SSRIs/SNRIs

  1. 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

  1. Susmano A, Volgman AS, Buckingham TA. Beneficial effects of dextro-amphetamine in the treatment of vasodepressor syncope. PACE 1993;16:1235-9.
  2. Grubb BP, Kosinski D, Mouhaffel A, Pothoulakis A. Use of methylphenidate in the treatment of refractory neurocardiogenic syncope. PACE 1996;19:836-40.
  3. Olson LG, Ambrogetti A, Sutherland DC. A pilot randomized controlled trial of dexamphetamine in patients with chronic fatigue syndrome. Psychosomatics 2003;44:38-43.
  4. 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

  1. 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.
  2. 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.
  3. Robertson D, et al. Clonidine raises blood pressure in severe idiopathic orthostatic hypotension. Am J Med 1983;74:193-200.
  4. 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.
  5. Boehm KE, et al. Neurocardiogenic syncope: response to hormonal therapy. Pediatrics 1997;99:623-5.
  6. 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.

 

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Author: Kay E. Jewell, MD
Page Last Updated: August 11, 2012