Midodrine for orthostatic hypotension and recurrent reflex syncope

@article{Izcovich2014MidodrineFO,
  title={Midodrine for orthostatic hypotension and recurrent reflex syncope},
  author={Ariel Izcovich and Carlos Gonz{\'a}lez Malla and Mat{\'i}as E Manzotti and Hugo Norberto Catalano and Gordon H. Guyatt},
  journal={Neurology},
  year={2014},
  volume={83},
  pages={1170 - 1177}
}
Objective: Symptomatic orthostatic hypotension (SOH) and recurrent reflex syncope (RRS) can be disabling. Midodrine has been proposed in the management of patients with these conditions but its impact on patient important outcomes remains uncertain. We performed a systematic review to evaluate the efficacy and safety of midodrine in patients with SOH and RRS. Methods: We searched multiple electronic databases without language restriction from their inception to June 2013. We included randomized… 
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Midodrine and droxidopa possess the most evidence with respect to increasing blood pressure and alleviating symptoms and emerging evidence with low-dose atomoxetine is promising, especially in those with central autonomic failure, and may prove to be a viable alternative treatment option.
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The aim of this study is to evaluate the management of patients with recurrent syncopal episodes focusing on pharmacological and non-pharmacological approaches.
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Two randomised controlled trials (RCTs) (n=171 and n=97) found that midodrine significantly increased standing blood pressure 1 hour post-dose compared with placebo in people with symptomatic
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TLDR
It is suggested that fludrocortisone is more effective than no medication in pediatric patients with VVS, and this retrospective observational single-tertiary-center study based on chart reviews suggests this.
Diagnostic and therapeutic approach to cardioinhibitory reflex syncope: A complex and controversial issue.
  • B. Rocha, R. Gomes, +5 authors C. Fonseca
  • Medicine
    Revista portuguesa de cardiologia : orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology
  • 2019
TLDR
A comprehensive review of the current literature and recent advances in cardiac pacing and pacing algorithms in VVS is performed, and the diagnostic and therapeutic approach to the complex patient with recurrent VVS and reduced quality of life is discussed.
Diagnostic and therapeutic approach to cardioinhibitory reflex syncope: A complex and controversial issue
TLDR
A comprehensive review of the current literature and recent advances in cardiac pacing and pacing algorithms in VVS is performed, and the diagnostic and therapeutic approach to the complex patient with recurrent VVS and reduced quality of life is discussed.
Neurogenic orthostatic hypotension – management update and role of droxidopa
TLDR
Management strategies for OH are presented, including the mechanism of action of droxidopa and various studies performed to assess its efficacy.
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