Midodrine yields the most consistent favourable outcome among pharmacological agents for neurocardiogenic syncope, but should be reserved for patients with recurrent and refractory syncope.
What is the clinical evidence for pharmacological therapies in treating neurocardiogenic syncope?
Midodrine is highlighted as the most consistently effective pharmacological agent for managing recurrent and refractory neurocardiogenic syncope.
Neurocardiogenic syncope is a neurally mediated disorder and is a common cause of syncope. The goal of treatment is to prevent recurrences with the aim of improving quality of life and reducing morbidity. Reassurance, in some cases, may suffice. In others, augmenting central blood volume by increasing fluid and/or salt intake is effective. The role of non-pharmacological physical manoeuvres is increasingly recognised, given the increasing clinical trial data supporting their efficacy. This review summarises the clinical evidence for a variety of pharmacological agents. Of these, midodrine appears to have yielded the most consistent favourable outcome. Its use, however, should be reserved for patients with recurrent and refractory syncope.
Chen et al. (Tue,) conducted a review in Neurocardiogenic syncope. Pharmacological therapies (e.g., midodrine) was evaluated. Midodrine yields the most consistent favourable outcome among pharmacological agents for neurocardiogenic syncope, but should be reserved for patients with recurrent and refractory syncope.