title: Fluoxetine hydrochloride for the treatment of severe refractory orthostatic hypotension.
abstract: OBJECTIVE
  To evaluate the usefulness of fluoxetine hydrochloride in the treatment of patients with severe refractory orthostatic hypotension.
  
  
  METHODS
  Prospective, nonrandomized study.
  
  
  METHODS
  Five patients (3 men, 2 women with a mean age of 67 +/- 7 years with chronic symptomatic orthostatic hypotension resistant to or intolerant of other therapies.
  
  
  METHODS
  Symptoms and orthostatic responses were recorded in the baseline state. Fluoxetine hydrochloride 20 mg orally once daily was started and patients were reevaluated after 6 to 8 weeks of therapy.
  
  
  RESULTS
  All patients demonstrated orthostatic hypotension (20 mm Hg or greater decline in systolic blood pressure) associated with symptoms (eg, dizziness, vertigo, near syncope) in the baseline state. After 6 to 8 weeks of fluoxetine therapy, 2 patients reported resolution of all symptoms, 2 had a marked reduction in symptoms, and 1 patient experienced no effect. Orthostatic responses were attenuated in 4 of the 5 patients (80%).
  
  
  CONCLUSIONS
  Fluoxetine hydrochloride may be an effective therapy for some patients with recurrent severe orthostatic hypotension refractory to other forms of therapy.
authors.affiliation: Department of Medicine, Medical College of Ohio, Toledo 43699.
authors.forename: B P
authors.initials: BP
authors.lastname: Grubb
authors.forename: D
authors.initials: D
authors.lastname: Samoil
authors.forename: D
authors.initials: D
authors.lastname: Kosinski
authors.forename: D
authors.initials: D
authors.lastname: Wolfe
authors.forename: M
authors.initials: M
authors.lastname: Lorton
authors.forename: E
authors.initials: E
authors.lastname: Madu
mesh_terms: D000368:Aged; D005260:Female; D005473:Fluoxetine / Q000627:therapeutic use*; D006801:Humans; D007024:Hypotension, Orthostatic / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D005473:Fluoxetine