Key result
Psychotherapy and antidepressants reduce recurrent vasovagal syncope in refractory cases.
Why the study?
The study was conducted to evaluate the correlation between vasovagal syncope and psychiatric status, and to determine if this association could serve as a therapeutic target.
Does the presence of psychiatric distress correlate with vasovagal syncope, and do psychotherapy and antidepressants reduce syncope recurrences in these patients?
Systematic Review (n=813)
Does the presence of psychiatric distress correlate with vasovagal syncope, and do psychotherapy and antidepressants reduce syncope recurrences in these patients?
Psychological assessment is important in vasovagal syncope, and targeted therapies like psychotherapy or SSRIs may be beneficial for patients with refractory syncope and concurrent psychosocial impairment.
Supports psychological assessment in vasovagal syncope; confirms anxiety/depression links and extends RCT evidence for psychotherapy and antidepressants in refractory cases.
Vasovagal syncope (VVS) is a transient, sudden loss of consciousness followed by complete resolution, usually due to a paradoxical autonomic reaction that results in hypotension and/or bradycardia. In this study, we assessed the correlation between VVS and a patient's psychiatric status, as well as if this association could be a target in the treatment of those patients. We conducted a systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched the available literature using the following databases: PubMed, Google Scholar, and ScienceDirect, with last access on July 21, 2022. The search resulted in 1691 articles, and inclusion and exclusion criteria were applied to nine remaining articles, all of which were accepted after using the quality assessment tools, four observational and four randomized controlled trials (RCTs). Four of the included studies assessed the correlation among vasovagal syncope, psychosocial impairment, and quality of life. We found a consistent correlation among VVS, psychosocial impairment, and quality of life (QoL), meaning that VVS patients usually have some degree of psychosocial impairment, especially in the form of anxiety and depression, and a poorer QoL in comparison to their healthy counterparts. The use of psychotherapy and antidepressants was proven to be effective in VVS in RCTs, but further evidence is needed.
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Abuzainah et al. (2022) conducted a systematic review in Vasovagal syncope (n=813). Psychotherapy and antidepressants (e.g., paroxetine, fluoxetine, amitriptyline) vs. Placebo, standard care, or healthy controls was evaluated on Correlation with psychosocial impairment and quality of life, and reduction in syncopal episodes. Vasovagal syncope is consistently associated with higher rates of anxiety and depression and poorer quality of life, while psychotherapy and antidepressants demonstrated effectiveness in reducing syncopal recurrences in refractory cases.
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