L-dihydroxyphenylserine (Droxidopa) in the treatment of orthostatic hypotension
@article{Mathias2007LdihydroxyphenylserineI,
title={L-dihydroxyphenylserine (Droxidopa) in the treatment of orthostatic hypotension},
author={Christopher J. Mathias},
journal={Clinical Autonomic Research},
year={2007},
volume={18},
pages={25-29}
}Neurogenic orthostatic hypotension is a cardinal feature of generalised autonomic failure and commonly is the presenting sign in patients with primary autonomic failure. Orthostatic hypotension can result in considerable morbidity and even mortality and is a major management problem in disorders such as pure autonomic failure, multiple system atrophy and also in Parkinson’s disease. Treatment is ideally two pronged, using non-pharmacological and pharmacological measures.Drug treatment ideally…
73 Citations
Droxidopa for the treatment of neurogenic orthostatic hypotension in neurodegenerative diseases
- MedicineExpert opinion on pharmacotherapy
- 2019
The authors review the effects of droxidopa in NOH with a focus on the neurodegenerative diseases PD, MSA, and pure autonomic failure (PAF, where results appear essentially similar) and indicates a positive yet short-lasting effect of the drug on OH Questionnaire composite score, light-headedness/dizziness score, and standing BP during the first two treatment-weeks.
L-DOPS and the treatment of neurogenic orthostatic hypotension
- Biology
- 2013
This review includes Phase II and III clinical trials undertaken that have examined the safety, efficacy and tolerability of DOPS in the treatment of neurogenic orthostatic hypotension.
Droxidopa for the treatment of neurogenic orthostatic hypotension and other symptoms of neurodegenerative disorders
- Medicine
- 2014
Results from a few small and short placebo-controlled trials and clinical studies in neurogenic OH showed significant reductions in the manometric drop of blood pressure after posture changes or meals, but larger Phase III studies suggest a positive effect of the drug on dizziness.
Droxidopa | MedChemExpress
- Biology
- 2019
The acute administration of droxidopa in PVL and BDL rats caused a significant and maintained increase in arterial pressure and mesenteric arterial resistance, with a significant decrease of mesenterIC arterial and portal blood flow, without changing portal pressure and renal blood flow.
Orthostatic hypotension in Parkinson's disease
- Medicine, Biology
- 2013
The most important unanswered questions about PD-related OH, which may be the result of pre- and post-ganglionic adrenergic denervation or cognitive dysfunction, are discussed.
Neurogenic orthostatic hypotension: roles of norepinephrine deficiency in its causes, its treatment, and future research directions
- Medicine, BiologyCurrent medical research and opinion
- 2015
Pressor agents are important for treating symptomatic NOH in patients unresponsive to lifestyle changes alone, however, the dysautonomia underlying NOH often permits blood-pressure excursions toward both hypotension and hypertension.
New Developments in the Management of Neurogenic Orthostatic Hypotension
- Medicine, BiologyCurrent Cardiology Reports
- 2014
Droxidopa was approved by the FDA in 2014 for the treatment of neurogenic OH associated with primary autonomic neuropathies including Parkinson disease, multiple system atrophy, and pure autonomic failure, in an attempt to provide a practical guide to its management.
Rascol , Olivier Emerging drugs for autonomic dysfunction in Parkinson ' s disease
- Medicine
- 2013
Evidence about the efficacy and safety of available treatments for autonomic dysfunction and potential targets for upcoming therapies are discussed, and preliminary evidence suggesting that fludrocortisone, domperidone, droxidopa or fipamezole may be effective for the treatment of orthostatic hypotension is suggested.
Emerging drugs for autonomic dysfunction in Parkinson's disease
- MedicineExpert opinion on emerging drugs
- 2013
Sound clinical trials are needed in order to allow firm evidence-based recommendations about these treatments, including BTX or behavioral therapy for urinary incontinence and lubiprostone and probiotics for constipation.
References
SHOWING 1-10 OF 18 REFERENCES
Norepinephrine Precursor Therapy in Neurogenic Orthostatic Hypotension
- Medicine, BiologyCirculation
- 2003
Acute administration of L-DOPS increases blood pressure and improves orthostatic tolerance in patients with NOH and the pressor effect results from conversion of L–aromatic amino acid decarboxylase to NE outside the central nervous system.
l-threo-dihydroxyphenylserine (l-threo-DOPS; droxidopa) in the management of neurogenic orthostatic hypotension: A multi-national, multi-center, dose-ranging study in multiple system atrophy and pure autonomic failure
- MedicineClinical Autonomic Research
- 2006
The dosage of 300 mg twice daily seemed to offer the most effective control of symptomatic orthostatic hypotension in MSA and PAF, with the 2 serious adverse events reported being a possible complication of the disease under study, and with no reports of supine hypertension.
EFFECT OF UNNATURAL NORADRENALINE PRECURSOR ON SYMPATHETIC CONTROL AND ORTHOSTATIC HYPOTENSION IN DOPAMINE-BETA-HYDROXYLASE DEFICIENCY
- BiologyThe Lancet
- 1987
Autonomic diseases: management
- MedicineJournal of neurology, neurosurgery, and psychiatry
- 2003
The management of autonomic disease encompasses a number of aspects. Of immediate and practical importance is alleviation of symptoms. The ideal is to rectify the autonomic deficit and cure the…
[Effects of L-threo-Dops on orthostatic hypotension in Parkinson's disease].
- MedicineNo to shinkei = Brain and nerve
- 1998
The group that showed improvement in orthostatic syncope had a significant improvement in decline in blood pressure by standing after administration of L-threo-Dops, while the group without any change in severity of syncope did not showsignificant improvement in Orthostatic hypotention.
EFNS guidelines on the diagnosis and management of orthostatic hypotension
- MedicineEuropean journal of neurology
- 2006
Evidence based guidelines for the diagnostic workup and the therapeutic management (non‐pharmacological and pharmacological) are provided based on the EFNS guidance regulations.
Autonomic diseases: clinical features and laboratory evaluation
- MedicineJournal of neurology, neurosurgery, and psychiatry
- 2003
The history of the autonomic nervous system is of particular importance in the consideration and recognition of autonomic disease, and in separating dysfunction that may result from non-autonomic disorders.
Clinical, autonomic and therapeutic observations in two siblings with postural hypotension and sympathetic failure due to an inability to synthesize noradrenaline from dopamine because of a deficiency of dopamine beta hydroxylase.
- BiologyThe Quarterly journal of medicine
- 1990
Treatment of both patients with the synthetic amino acid, d-l-threo-dihydroxyphenylserine, which contains a hydroxyl group and is converted to noradrenaline by dopa-decarboxylase, reduced symptoms and signs of postural hypotension and increased levels of plasma nor adrenaline and its urinary metabolites.
Pharmacokinetic studies of oral L-threo-3,4-dihydroxyphenylserine in normal subjects and patients with familial amyloid polyneuropathy
- Medicine, BiologyEuropean Journal of Clinical Pharmacology
- 2004
It was concluded that the effects on plasma norepinephrine and blood pressure of oralL-threo-DOPS were essentially equal to those of twice as large a dose ofDl- threo -3,4-dihydroxyphenylserine.
Cognitive functioning in orthostatic hypotension due to pure autonomic failure
- PsychologyClinical Autonomic Research
- 2006
It is speculated that the cognitive impairments associated with PAF represent consequences of systemic hypotension with cerebral underperfusion, however, a failure in integrated bodily arousal responses during cognitive behaviours may also contribute to some of the observed deficits.