Neurocardiogenic syncope: latest pharmacological therapies.
Neurocardiogenic syncope is a neurally mediated disorder and is a common cause of syncope. The goal of treatment is to prevent recurrences with the aim of improving quality of life and reducing morbidity. Reassurance, in some cases, may suffice. In others, augmenting central blood volume by increasing fluid and/or salt intake is effective. The role of non-pharmacological physical manoeuvres is increasingly recognised, given the increasing clinical trial data supporting their efficacy. This review summarises the clinical evidence for a variety of pharmacological agents. Of these, midodrine appears to have yielded the most consistent favourable outcome. Its use, however, should be reserved for patients with recurrent and refractory syncope.
Chen
Lin Y
LY
Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, Minnesota, MN 55905, USA. chen.lin@mayo.edu
Shen
Win-Kuang
WK
D000316:Adrenergic alpha-Agonists / Q000494:pharmacology / Q000627:therapeutic use*; D000319:Adrenergic beta-Antagonists / Q000494:pharmacology / Q000627:therapeutic use*; D001262:Atenolol / Q000494:pharmacology / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects; D005473:Fluoxetine / Q000494:pharmacology / Q000627:therapeutic use; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008879:Midodrine / Q000494:pharmacology / Q000627:therapeutic use; D010353:Patient Education as Topic; D017410:Practice Guidelines as Topic; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D055502:Secondary Prevention; D017367:Selective Serotonin Reuptake Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D019462:Syncope, Vasovagal / Q000188:drug therapy* / Q000503:physiopathology / Q000517:prevention & control
D000316:Adrenergic alpha-Agonists; D000319:Adrenergic beta-Antagonists; D001262:Atenolol; D005473:Fluoxetine; D008879:Midodrine; D017367:Selective Serotonin Reuptake Inhibitors