Abstract | OBJECTIVES: BACKGROUND: METHODS: Sixty-eight consecutive patients (26 men and 42 women, mean age 44.7+/-16.5 years) with recurrent syncope and positive head-up tilt test and in whom standard therapies with beta-adrenergic blocking agents, vagolytic, negative inotropic or mineral corticoid agents were ineffectual or poorly tolerated were referred for study. Patients randomly received either paroxetine at 20 mg once a day or a placebo. A head-up tilt test was then reperformed after one month of treatment, and the clinical effect was noted over a mean follow-up of 25.4+/-7.9 months. RESULTS: The response rates (negative tilt test) after one month of treatment were 61.8% versus 38.2% (p < 0.001) in the paroxetine and placebo groups, respectively. During follow-up spontaneous syncope was reported in six patients (17.6%) in the paroxetine group as compared to 18 patients (52.9%) in the placebo group (p < 0.0001). Only one patient (2.9%) asked to be discontinued from the drug for severe side effects. CONCLUSIONS:
Paroxetine was found to significantly improve the symptoms of patients with vasovagal syncope unresponsive to or intolerant of traditional medications and was well tolerated by patients.
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Authors | E Di Girolamo, C Di Iorio, P Sabatini, L Leonzio, C Barbone, A Barsotti |
Journal | Journal of the American College of Cardiology
(J Am Coll Cardiol)
Vol. 33
Issue 5
Pg. 1227-30
(Apr 1999)
ISSN: 0735-1097 [Print] United States |
PMID | 10193720
(Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Serotonin Uptake Inhibitors
- Paroxetine
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Topics |
- Acute Disease
- Adult
- Double-Blind Method
- Electrocardiography, Ambulatory
- Female
- Follow-Up Studies
- Humans
- Male
- Middle Aged
- Paroxetine
(therapeutic use)
- Refractory Period, Electrophysiological
(drug effects)
- Secondary Prevention
- Selective Serotonin Reuptake Inhibitors
(therapeutic use)
- Syncope, Vasovagal
(diagnosis, drug therapy, physiopathology)
- Tilt-Table Test
- Treatment Outcome
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