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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
Summary
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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