title: Droxidopa in the Treatment of Postural Orthostatic Tachycardia Syndrome.
abstract: BACKGROUND
  Postural orthostatic tachycardia syndrome (POTS) is a constellation of signs and symptoms that occur when a patient is upright and relieved by recumbence. Currently, no drugs are labeled for the treatment for POTS. Droxidopa is an orally administered amino acid that is converted to norepinephrine and thought to improve both blood pressure and symptoms in patients with orthostatic intolerance.
  
  
  OBJECTIVE
  To appraise the effect of Droxidopa in a clinical setting in patients with POTS refractory to other forms of treatment.
  
  
  METHODS
  A retrospective study of patients with POTS at our Syncope and Autonomic Disorders Center. Three hundred fifty-two patients were screened, 54 of them were prescribed Droxidopa and found to be eligible to include in our study.
  Symptoms of orthostatic intolerance, side effects of therapy and response to treatment. Statistical analyses were done using SPSS software. Thirty-seven patients were included in data analysis. Patients who failed to follow up, didn't obtain Droxidopa due to insurance and cost concerns, had hypertensive response to therapy or had allergic reaction were excluded from data analysis.
  
  
  RESULTS
  The most frequently reported symptom was dizziness in 91.9% of patients, followed by syncope and fatigue in 70.3% and 67.6% of patients, respectively. Symptoms of dizziness, syncope and fatigue were reported less after treatment; 75.7%, 51.4% and 40.5%, respectively. There was no statistically significant difference in standing or sitting blood pressure before and after treatment. Despite the improvement in some symptoms. Only 27% of patients reported improved quality of life after treatment. Of total, 40.5% of patients stopped the treatment either due to side effects or ineffectiveness.
  
  
  CONCLUSIONS
  Droxidopa appears to improve some symptoms of orthostatic intolerance in patients with POTS but has diminutive impact on quality of life and blood pressure. Further assessment in large clinical trials is needed to evaluate its efficacy.
authors: Departments of 1Internal Medicine and 2Cardiovascular, University of Toledo Medical Center, Toledo, OH.
authors: Mohammed
authors: M
authors: Ruzieh
authors: Osama
authors: O
authors: Dasa
authors: Ann
authors: A
authors: Pacenta
authors: Beverly
authors: B
authors: Karabin
authors: Blair
authors: B
authors: Grubb
mesh_terms: D000328:Adult; D000368:Aged; D000978:Antiparkinson Agents / Q000627:therapeutic use*; D004244:Dizziness / Q000209:etiology; D015103:Droxidopa / Q000627:therapeutic use*; D005221:Fatigue / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D054972:Postural Orthostatic Tachycardia Syndrome / Q000150:complications / Q000188:drug therapy*; D012189:Retrospective Studies; D013575:Syncope / Q000209:etiology; D016896:Treatment Outcome
chemical_list: D000978:Antiparkinson Agents; D015103:Droxidopa