Atomoxetine as an adjunct to nonpharmacological treatments for preventing vasovagal attacks in patients with recurrent vasovagal syncope: A pilot randomized-controlled trial

Tajdini, Masih; Aminorroaya, Arya; Tavolinejad, Hamed; Tofighi, Saeed; Jalali, Arash; Sadeghian, Saeed; Vasheghani‐Farahani, Ali; Yadangi, Somayeh; Shahmansouri, Nazila; Akhondzadeh, Shahin; Bozorgi, Ali

doi:10.1016/j.ijcha.2021.100789

Cited by 3 publications

(3 citation statements)

References 30 publications

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“…Atomoxetine was shown to reduce the risk of TT-induced syncope by attenuating reflex bradycardia and preventing the progression of presyncope to syncope [73,74]. Moreover, in a recent double-blind placebo-controlled trial, atomoxetine significantly reduced the risk of (pre)syncope and prolonged presyncope-free survival in vasovagal syncope with greater benefit in participants with systolic BP <110 mm Hg [75].…”

Section: Pharmacological Therapiesmentioning

confidence: 99%

Syncope: new solutions for an old problem

et al. 2021

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Section: Pharmacological Therapiesmentioning

confidence: 99%

Syncope: new solutions for an old problem

et al. 2021

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“…Foi demonstrado que a atomoxetina reduz o risco de síncope induzida por TT, atenuando a bradicardia reflexa e prevenindo a progressão da pré-síncope para síncope 77,78 . Em um ensaio duplo-cego controlado por placebo, a atomoxetina reduziu significativamente o risco de (pré) síncope e prolongou a sobrevida livre de pré-síncope na síncope vasovagal, com maior benefício em participantes com PA sistólica <110 mm Hg 79 .…”

Section: Terapias Farmacológicasunclassified

Mecanismos Fisiopatológicos, Avaliação Clínica E Abordagens Terapêuticas Da Síncope

Okusu,

Silva,

Gama

et al. 2024

Saúde Cardiovascular: Conhecimento, Prevenção E Cuidado

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“…The pathophysiology of VVS is poorly understood, and there are ongoing efforts to address this gap in order to introduce novel treatment strategies for this potentially debilitating condition. 30 According to a hypothesis, 31 VVS is characterized by an over activation of the parasympathetic nervous system in response to an exaggerated activation of the sympathetic nervous system, demonstrated by increased serum levels of catecholamines. [14][15][16][17][18][19] Patients with VVS have normal resting serum levels of catecholamines; nevertheless, their serum catecholamines start to rise in response to head-up tilting, a similar situation to an actual syncopal episode.…”

Section: Biochemical Mechanism Of Vvs In Vitamin B12/folate Deficiencymentioning

confidence: 99%

Association of Vitamin B12 and Folate Deficiency with Vasovagal Syncope: A Case-Control Study

Aminorroaya

Vasheghani‐Farahani²,

Tavolinejad³

et al. 2023

Preprint

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Aims: There is some clinical evidence of the association between vitamin B12 deficiency and vasovagal syncope (VVS) in pediatric patients. We aimed to investigate the possible association of vitamin B12 and folate deficiency with VVS in adults. Methods: In this case-control study, we included adult patients with VVS who presented to our tertiary syncope unit for a head-up tilt table test as the case group. We selected age- and sex-matched individuals without any history of syncope from the population-based Tehran Cohort Study as the control group. The exclusion criteria included but were not restricted to taking vitamin B supplements, carbamazepine, or phenobarbital, and sleeve gastrectomy. We measured and compared serum levels of vitamin B12, folate, and homocysteine. Results: From February 2020 to February 2021, we included 44 patients in the case group, matched with 44 controls, with a mean age of 37.9 years and 23 (52.3%) females in each group. There was no statistically significant difference between the study groups regarding vitamin B12 or folate deficiency, or their serum levels. The serum level of vitamin B12 was remarkably lower in patients with frequent VVS (≥3 lifetime episodes) compared to patients with infrequent VVS (<3 lifetime episodes) [233.8 (80.7) versus 305.2 (118.1) pg/mL; P=0.042] and this association remained significant after adjustment for possible confounders (P=0.026). Conclusion: We found no association between vitamin B12 or folate deficiency, or their serum levels and VVS; nevertheless, frequent VVS, compared to infrequent VVS, was associated with a lower serum vitamin B12.

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Atomoxetine as an adjunct to nonpharmacological treatments for preventing vasovagal attacks in patients with recurrent vasovagal syncope: A pilot randomized-controlled trial

Cited by 3 publications

References 30 publications

Syncope: new solutions for an old problem

Syncope: new solutions for an old problem

Mecanismos Fisiopatológicos, Avaliação Clínica E Abordagens Terapêuticas Da Síncope

Association of Vitamin B12 and Folate Deficiency with Vasovagal Syncope: A Case-Control Study

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