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Pharmacotherapy of neurally mediated syncope

D G Benditt1, G J Fahy, K G Lurie

  • 1Cardiac Arrhythmia Center, Department of Medicine, University of Minnesota Medical School, Minneapolis 55455, USA.

Circulation
|September 14, 1999
PubMed

Insights

Preventing recurrent neurally mediated syncope, particularly vasovagal syncope, lacks proven long-term drug effectiveness. Current favored treatments include beta-blockers and volume-increasing agents, with others under investigation.

Area of Science:

  • Cardiology
  • Pharmacology
  • Neurology

Background:

  • Recurrent neurally mediated syncope, especially vasovagal syncope, is managed with various pharmacological agents.
  • Current treatments lack definitive long-term efficacy proven by randomized clinical trials.

Purpose of the Study:

  • To review current pharmacological strategies for preventing recurrent neurally mediated syncope.
  • To highlight the need for more robust clinical trials to establish treatment foundations.

Main Methods:

  • Review of existing literature on pharmacological interventions for neurally mediated syncope.
  • Discussion of favored and investigational drug classes.

Main Results:

  • Beta-adrenergic receptor blockade and agents increasing central volume are currently favored.
  • Disopyramide, serotonin reuptake blockers, and midodrine show potential but require further study.

Conclusions:

  • No pharmacological agent has unequivocally proven long-term effectiveness for preventing recurrent neurally mediated syncope.
  • Further research into pathophysiology and well-designed placebo-controlled trials are essential for establishing effective pharmacological prevention.

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