title: [Comparison of metoprolol vs clonazepam as a first treatment choice among patients with neurocardiogenic syncope].
abstract: OBJECTIVE
  We compared the effects of a metoprolol and clonazepam in patients with neurocardiogenic syncope.
  
  
  METHODS
  We compared the effects of a metoprolol and clonazepam in a prospective, randomised trial in 54 patients. Patients were randomly assigned to metoprolol (starting dose 50 mg bid) or clonazepam (starting dose 0.5 mg qd). We assessed a primary combined endpoint of syncope and pre-syncope on a follow-up of 12 months.
  
  
  RESULTS
  The primary combined endpoint of syncope and presyncope occurred in the metoprolol group in 3, 4, and 10% of patients at 3, 6, and 12 months respectively. In the clonazepam group it was no recurrence in the first 6 months, and 5% recurrence at 12 months follow-up (nonsignificant differences between groups). Clinical symptoms commonly associated with neurally mediated syncope were decreased similarly in both treatment groups, in the metoprolol group from 5.2+/-2.5 to 1.9+/-2.1 (p < 0.001) and in the clonazepam group from 5.5+/-2.5 to 1.5+/-2.2 (p<0.001).
  
  
  CONCLUSIONS
  Pharmacological treatment of neurocardiogenic syncope with metoprolol or clonazepam resulted in similar prevention of syncope and presyncope. Both treatments decreased clinical symptoms but complete symptomatic resolution was rarely observed.
authors.affiliation: Departamento de Electrocardiología, Instituto Nacional de Cardiología Ignacio Chávez, SSA, Tlalpan, México DF, México. manliomarquez@yahoo.com
authors.forename: Manlio F
authors.initials: MF
authors.lastname: Márquez
authors.forename: Karla
authors.initials: K
authors.lastname: Urias-Medina
authors.forename: Jorge
authors.initials: J
authors.lastname: Gómez-Flores
authors.forename: Ayax
authors.initials: A
authors.lastname: Sobrino
authors.forename: Arturo
authors.initials: A
authors.lastname: Sotomayor-González
authors.forename: Antonio
authors.initials: A
authors.lastname: González-Hermosillo
authors.forename: Manuel
authors.initials: M
authors.lastname: Cárdenas
mesh_terms: D000293:Adolescent; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000328:Adult; D002648:Child; D002998:Clonazepam / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008790:Metoprolol / Q000627:therapeutic use*; D008875:Middle Aged; D011446:Prospective Studies; D019462:Syncope, Vasovagal / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D000319:Adrenergic beta-Antagonists; D002998:Clonazepam; D008790:Metoprolol