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[Treatment of orthostatic hypotension with metoclopramide]
U G Cunha1, E R de Albuquerque
1Instituto de Previdência dos Servidores do Estado de Minas Gerais, Belo Horizonte.
A 38 year-old woman, with orthostatic hypotension secondary to autonomic dysfunction accompanied by sympathetic hyperactivity and excess of dopamine, was treated with an antagonistic dopaminergic drug, metoclopramide, 30 mg/day, with good tolerance. Support intervention as well as the use of various drugs (beta-blockers, caffeine, fludrocortisone, haloperidol) showed no effect. The answer to metoclopramide both subjective and objective were remarkable. The way in which metoclopramide acts has not yet been fully clarified. Being a widely used drug, well tolerated, its use must be considered in cases of severe orthostatic hypotension, especially those with an excess of dopamine.
A 38 year-old woman, with orthostatic hypotension secondary to autonomic dysfunction accompanied by sympathetic hyperactivity and excess of dopamine, was treated with an antagonistic dopaminergic drug, metoclopramide, 30 mg/day, with good tolerance. Support intervention as well as the use of various drugs (beta-blockers, caffeine, fludrocortisone, haloperidol) showed no effect. The answer to metoclopramide both subjective and objective were remarkable. The way in which metoclopramide acts has not yet been fully clarified. Being a widely used drug, well tolerated, its use must be considered in cases of severe orthostatic hypotension, especially those with an excess of dopamine.