Efficacy of Midodrine vs Placebo in Neurogenic Orthostatic Hypotension: A Randomized, Double-blind Multicenter Study
Abstract
Objective. —To evaluate the efficacy of a 10-mg dose of midodrine 3 times per day in improving blood pressure (BP) and ameliorating symptoms of orthostatic hypotension in patients with neurogenic orthostatic hypotension. Midodrine hydrochloride, an α=agonist, could improve orthostatic BP by increasing vasomotor and venomotor tone. Design/Methods. —A total of 171 patients with orthostatic hypotension participated in a multicenter, randomized, placebo-controlled study. They were randomized to a 10-mg dose of midodrine or placebo 3 times per day in a 6-week study, comprising single-blind run-in (at week 1) and washout at weeks 5 and 6, with an intervening double-blind period (weeks 2 to 4). Setting. —Twenty-five centers, with most patients evaluated in referral centers. Main Outcome Measures. —The primary end points were improvement in standing systolic BP, symptoms of lightheadedness, and a global symptom relief score (by the investigator and patient separately). Results. —Nine patients were not evaluable because of noncompliance or taking concomitant vasoactive medications (3 in the midodrine group, 6 in the placebo group). In the evaluable patients, midodrine resulted in improvements in standing systolic BP at all time points (P<.001 at visits 2,3,4, and 5), in reported symptoms by the end of the second week of treatment (P=.001), and in the global symptom relief score rated by both the patient (P=.03) and the investigator (P<.001). There was no effect by center, severity of orthostatic hypotension, use of fludrocortisone or compression garments, or diagnosis. The main adverse effects were those of pilomotor reactions, urinary retention, and supine hypertension. Conclusions. —Midodrine is efficacious and safe in the treatment of neurogenic orthostatic hypotension.
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Midodrine was shown to be effective in three randomized placebo-controlled trials.
“Midodrine (2.5-10 mg t.i.d) was shown to be effective in three randomized placebo-controlled trials. 324-326”
From 2018 ESC Guidelines for the diagnosis and management of syncope (2018) · cites this paper as [325]
Midodrine increases BP both in the supine and upright posture and ameliorates symptoms of OH.
“There is no doubt that midodrine increases BP both in the supine and upright posture, and ameliorates the symptoms of OH.”
From 2018 ESC Guidelines for the diagnosis and management of syncope (2018) · cites this paper as [325]
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Brignole, M., Moya, A., de Lange, F. J., Deharo, J.-C., Elliott, P. M., Fanciulli, A., Fedorowski, A., Furlan, R., Kenny, R. A., Martín, A., et al. (2018) · European Heart Journal · doi:10.1093/eurheartj/ehy037 · Cited by 1,951 · see citing works
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BackgroundWenning, G. K., Colosimo, C., Geser, F., & Poewe, W. H. (2004) · The Lancet Neurology · doi:10.1016/s1474-4422(03)00662-8 · Cited by 467 · see citing works
Gibbons, C. H., Schmidt, P., Biaggioni, I., Frazier-Mills, C., Freeman, R., Isaacson, S., Karabin, B., Kuritzky, L., Lew, M., Low, P., et al. (2017) · Journal of Neurology · doi:10.1007/s00415-016-8375-x · Cited by 455 · see citing works
Self-citationShen, W.-K., Sheldon, R. S., Benditt, D. G., Cohen, M. I., Forman, D. E., Goldberger, Z. D., Grubb, B. P., Hamdan, M. H., Krahn, A. D., Link, M. S., et al. (2017) · Circulation · doi:10.1161/cir.0000000000000499 · Cited by 453 · see citing works
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BackgroundShen, W.-K., Sheldon, R. S., Benditt, D. G., Cohen, M. I., Forman, D. E., Goldberger, Z. D., Grubb, B. P., Hamdan, M. H., Krahn, A. D., Link, M. S., et al. (2017) · Circulation · doi:10.1161/cir.0000000000000498 · Cited by 408 · see citing works
Neurogenic Orthostatic Hypotension
Freeman, R. (2008) · New England Journal of Medicine · doi:10.1056/nejmcp074189 · Cited by 384 · see citing works
Orthostatic Hypotension in the Elderly: Diagnosis and Treatment
Gupta, V., & Lipsitz, L. A. (2007) · The American Journal of Medicine · doi:10.1016/j.amjmed.2007.02.023 · Cited by 388 · see citing works
Ferreira, J. J., Katzenschlager, R., Bloem, B. R., Bonuccelli, U., Burn, D. J., Deuschl, G., Dietrichs, E., Fabbrini, G., Friedman, A., Kaňovský, P., et al. (2012) · European Journal of Neurology · doi:10.1111/j.1468-1331.2012.03866.x · Cited by 359 · see citing works
EFNS guidelines on the diagnosis and management of orthostatic hypotension
Lahrmann, H., Cortelli, P., Hilz, M., Mathias, C. J., Struhal, W., & Tassinari, M. (2006) · European Journal of Neurology · doi:10.1111/j.1468-1331.2006.01512.x · Cited by 334 · see citing works
2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients With Syncope
Shen, W.-K., Sheldon, R. S., Benditt, D. G., Cohen, M. I., Forman, D. E., Goldberger, Z. D., Grubb, B. P., Hamdan, M. H., Krahn, A. D., Link, M. S., et al. (2017) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2017.03.003 · Cited by 327 · see citing works
Freeman, R. L., Abuzinadah, A. R., Gibbons, C. H., Jones, P. K., Miglis, M. G., & Sinn, D.-I. (2018) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2018.05.079 · Cited by 286 · see citing works
Droxidopa for neurogenic orthostatic hypotension
Kaufmann, H., Freeman, R. L., Biaggioni, I., Low, P. A., Pedder, S. C. J., Hewitt, L. A., Mauney, J., Feirtag, M., & Mathias, C. J. (2014) · Neurology · doi:10.1212/wnl.0000000000000615 · Cited by 279 · see citing works
Self-citationTreatment interventions for Parkinson's disease: an evidence based assessment
Rascol, O., Goetz, C. G., Koller, W. C., Poewe, W. H., & Sampaio, C. (2002) · The Lancet · doi:10.1016/s0140-6736(02)08520-3 · Cited by 279 · see citing works
Guía de práctica clínica para el diagnóstico y manejo del síncope (versión 2009)
Moya‐Mitjans, À., Sutton, R., Ammirati, F., Blanc, J., Brignole, M., Dahm, J. B., Deharo, J., Gajek, J. J., Gjesdal, K., Krahn, A. D., et al. (2009) · Revista Española de Cardiología (English Edition) · doi:10.1016/s1885-5857(09)73541-8 · Cited by 277 · see citing works
Treatment of autonomic dysfunction in Parkinson disease and other synucleinopathies
Palma, J., & Kaufmann, H. (2018) · Movement Disorders · doi:10.1002/mds.27344 · Cited by 246 · see citing works
Beh, S. C., Greenberg, B. M., Frohman, T. C., & Frohman, E. M. (2012) · Neurologic Clinics · doi:10.1016/j.ncl.2012.09.008 · Cited by 252 · see citing works
Non-motor symptoms in Parkinson’s disease
Park, A., & Stacy, M. A. (2009) · Journal of Neurology · doi:10.1007/s00415-009-5240-1 · Cited by 235 · see citing works
“Orthostatic hypotension can be treated with salt, fludrocortisone, midodrine and droxidopa [30, 33, 38].”
BackgroundManagement of neurogenic orthostatic hypotension: an update
Low, P. A., & Singer, W. (2008) · The Lancet Neurology · doi:10.1016/s1474-4422(08)70088-7 · Cited by 224 · see citing works
Self-citationOrthostatic Hypotension and Falls in Older Adults: A Systematic Review and Meta-analysis
Mol, A., Hoang, P. T. S. B., Sharmin, S., Reijnierse, E. M., Wezel, R. J. A. V., Meskers, C. G. M., & Maier, A. B. (2018) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2018.11.003 · Cited by 199 · see citing works
Singer, W. (2003) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp.74.9.1294 · Cited by 196 · see citing works
Preventing and treating orthostatic hypotension: As easy as A, B, C
Figueroa, J. J., Basford, J. R., & Low, P. A. (2010) · Cleveland Clinic Journal of Medicine · doi:10.3949/ccjm.77a.09118 · Cited by 191 · see citing works
Self-citationOrthostatic H ypotension in P arkinson D isease: H ow M uch Y ou F all or H ow L ow Y ou G o?
Palma, J., Gómez‐Esteban, J. C., Norcliffe‐Kaufmann, L., Martínez, J. A. B., Tijero, B., Berganzo, K., & Kaufmann, H. (2015) · Movement Disorders · doi:10.1002/mds.26079 · Cited by 181 · see citing works
Norepinephrine Precursor Therapy in Neurogenic Orthostatic Hypotension
Kaufmann, H., Saadia, D., Voustianiouk, A., Goldstein, D. S., Holmes, C. S., Yahr, M. D., Nardin, R. A., & Freeman, R. L. (2003) · Circulation · doi:10.1161/01.cir.0000083721.49847.d7 · Cited by 177 · see citing works
Multiple system atrophy: insights into a rare and debilitating movement disorder
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Horstink, M. W. I. M., TOLOSA, E. S., Bonuccelli, U., Deuschl, G., Friedman, A., Kaňovský, P., Larsen, J. O., Lees, A. J., Oertel, W. H., Poewe, W. H., et al. (2006) · European Journal of Neurology · doi:10.1111/j.1468-1331.2006.01548.x · Cited by 171 · see citing works
Drug-Related Orthostatic Hypotension: Beyond Anti-Hypertensive Medications
Rivasi, G., Rafanelli, M., Mossello, E., Brignole, M., & Ungar, A. (2020) · Drugs & Aging · doi:10.1007/s40266-020-00796-5 · Cited by 186 · see citing works
Podoleanu, C., Maggi, R., Brignole, M., Croci, F., Incze, A., Solano, A., Puggioni, E., & Carasca, E. (2006) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2006.06.052 · Cited by 165 · see citing works
Shen, W.-K., Sheldon, R. S., Benditt, D. G., Cohen, M. I., Forman, D. E., Goldberger, Z. D., Grubb, B. P., Hamdan, M. H., Krahn, A. D., Link, M. S., et al. (2017) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2017.03.002 · Cited by 155 · see citing works
“in patients with syncope due to neurogenic OH.(300-309) in patients with syncope due to neurogenic OH.”
BackgroundOrthostatic Hypotension: Mechanisms, Causes, Management
Low, P. A., & Tomalia, V. A. (2015) · Journal of Clinical Neurology · doi:10.3988/jcn.2015.11.3.220 · Cited by 149 · see citing works
Self-citationBiaggioni, I., Freeman, R. L., Mathias, C. J., Low, P. A., Hewitt, L. A., & Kaufmann, H. (2014) · Hypertension · doi:10.1161/hypertensionaha.114.04035 · Cited by 145 · see citing works
Self-citationNeurogenic orthostatic hypotension: pathophysiology, evaluation, and management
Metzler, M., Duerr, S., Granata, R., Krismer, F., Robertson, D., & Wenning, G. K. (2012) · Journal of Neurology · doi:10.1007/s00415-012-6736-7 · Cited by 139 · see citing works
“In two multi-centre double-blind placebocontrolled studies midodrine mediated beneficial effects that ameliorated orthostatic symptoms and increased standing blood pressure [42, 81].”
BackgroundSchoffer, K. L., Henderson, R. D., O’Maley, K. A., & O’Sullivan, J. D. (2007) · Movement Disorders · doi:10.1002/mds.21428 · Cited by 137 · see citing works
Angeli, P., Volpin, R., Piovan, D., et al. (1998) · Hepatology · doi:10.1002/hep.510280407 · Cited by 138 · see citing works
Midodrine for orthostatic hypotension and recurrent reflex syncope: A systematic review
Izcovich, A., González Malla, C., Manzotti, M., Catalano, H. N., & Guyatt, G. (2014) · Neurology · doi:10.1212/wnl.0000000000000815 · Cited by 131 · see citing works
Levodopa strengths and weaknesses
Jankovic, J. J. (2002) · Neurology · doi:10.1212/wnl.58.suppl_1.s19 · Cited by 131 · see citing works
Karas, B. J., Grubb, B. P., BOEHM, K., & Kip, K. T. (2000) · Pacing and Clinical Electrophysiology · doi:10.1111/j.1540-8159.2000.tb06760.x · Cited by 129 · see citing works
Orthostatic Hypotension: Management of a Complex, But Common, Medical Problem
Fedorowski, A., Ricci, F., Hamrefors, V., Sandau, K. E., Chung, T., Muldowney, J. A. S., Gopinathannair, R., & Olshansky, B. (2022) · Circulation Arrhythmia and Electrophysiology · doi:10.1161/circep.121.010573 · Cited by 120 · see citing works
Ramirez, C. E., Okamoto, L. E., Arnold, A. C., Gamboa, A. C., Diedrich, A., Choi, L., Raj, S. R., Robertson, D., Biaggioni, I., & Shibao, C. A. (2014) · Hypertension · doi:10.1161/hypertensionaha.114.04225 · Cited by 121 · see citing works
“The use of midodrine, however, is limited in some patients by adverse effects, such as pilomotor reactions, pruritus of the scalp, urinary urgency or retention, and supine hypertension.(4,27) Furthermore, previous reports have described that midodrine may not work in a subgroup of patients with autonomic failure.”
BackgroundMethodManagement of non-motor symptoms in advanced Parkinson disease
Truong, D. D., Bhidayasiri, R., & Wolters, E. C. (2007) · Journal of the Neurological Sciences · doi:10.1016/j.jns.2007.08.015 · Cited by 117 · see citing works
“Randomized controlled trials in patients with neurogenic orthostatic hypotension, some of whom have PD, support the use of midodrine [31,32].”
BackgroundInvited Article: Autonomic ganglia
Vernino, S. A., Sandroni, P., Singer, W., & Low, P. A. (2008) · Neurology · doi:10.1212/01.wnl.0000312280.44805.5d · Cited by 116 · see citing works
Self-citationMathias, C. J., Sénard, J., Braune, S., Watson, L. P. E., Aragishi, A., Keeling, J. E., & Taylor, M. D. (2001) · Clinical Autonomic Research · doi:10.1007/bf02298955 · Cited by 115 · see citing works
Pathophysiology, Diagnosis, and Treatment of Orthostatic Hypotension and Vasovagal Syncope
Medow, M. S., Stewart, J. M., Sanyal, S., Mumtaz, A., Sica, D. A., & Frishman, W. H. (2007) · Cardiology in Review · doi:10.1097/crd.0b013e31815c8032 · Cited by 112 · see citing works
“Careful dietary instruction is also important in the nonpharmacologic management of the patient with OH.”
BackgroundInfluentialGrubb, B. P., & Karas, B. J. (1999) · Pacing and Clinical Electrophysiology · doi:10.1111/j.1540-8159.1999.tb00546.x · Cited by 107 · see citing works
The efficacy of midodrine hydrochloride in the treatment of children with vasovagal syncope
Qingyou, Z., Junbao, D., & Chaoshu, T. (2006) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2006.07.031 · Cited by 108 · see citing works
Orthostatic hypotension: A review
Joseph, A., Wanono, R., Flamant, M., & Vidal‐Petiot, E. (2017) · Néphrologie & Thérapeutique · doi:10.1016/j.nephro.2017.01.003 · Cited by 109 · see citing works
Management of Orthostatic Hypotension in Parkinson’s Disease
Fanciulli, A., Leys, F., Falup‐Pecurariu, C., Thijs, R. D., & Wenning, G. K. (2020) · Journal of Parkinson s Disease · doi:10.3233/jpd-202036 · Cited by 108 · see citing works
Orthostatic Hypotension in Parkinson Disease
Palma, J., & Kaufmann, H. (2019) · Clinics in Geriatric Medicine · doi:10.1016/j.cger.2019.09.002 · Cited by 109 · see citing works
Evidence-based treatment of neurogenic orthostatic hypotension and related symptoms
Eschlböck, S., Wenning, G. K., & Fanciulli, A. (2017) · Journal of Neural Transmission · doi:10.1007/s00702-017-1791-y · Cited by 102 · see citing works
Pasnoor, M., Dimachkie, M. M., Kluding, P. M., & Barohn, R. J. (2013) · Neurologic Clinics · doi:10.1016/j.ncl.2013.02.004 · Cited by 101 · see citing works
Evidence of Small-Fiber Polyneuropathy in Unexplained, Juvenile-Onset, Widespread Pain Syndromes
Oaklander, A. L., & Klein, M. M. (2013) · PEDIATRICS · doi:10.1542/peds.2012-2597 · Cited by 99 · see citing works
Wenning, G. K., & Braune, S. (2001) · CNS Drugs · doi:10.2165/00023210-200115110-00003 · Cited by 102 · see citing works
The treatment of neurogenic orthostatic hypotension with 3,4-DL-threo-dihydroxyphenylserine
Freeman, R. L., Landsberg, L., & Young, J. (1999) · Neurology · doi:10.1212/wnl.53.9.2151 · Cited by 98 · see citing works
Management of Motor and Non-Motor Symptoms in Parkinson’s Disease
Sprenger, F., & Poewe, W. H. (2013) · CNS Drugs · doi:10.1007/s40263-013-0053-2 · Cited by 99 · see citing works
Efficacy of treatments for orthostatic hypotension: a systematic review
Logan, I., & Witham, M. D. (2012) · Age and Ageing · doi:10.1093/ageing/afs061 · Cited by 93 · see citing works
Orthostatic hypotension in older people: considerations, diagnosis and management
Dani, M., Dirksen, A., Taraborrelli, P., Panagopolous, D., Torocastro, M., Sutton, R., & Lim, P. B. (2021) · Clinical Medicine · doi:10.7861/clinmed.2020-1044 · Cited by 97 · see citing works
Magkas, N., Tsioufis, C. P., Thomopoulos, C., Dilaveris, P., Georgiopoulos, G. A., Sanidas, E. A., Papademetriou, V., & Tousoulis, D. M. (2019) · Journal of Clinical Hypertension · doi:10.1111/jch.13521 · Cited by 95 · see citing works
L‐Dihydroxyphenylserine (L‐DOPS): A Norepinephrine Prodrug
Goldstein, D. S. (2006) · Cardiovascular Drug Reviews · doi:10.1111/j.1527-3466.2006.00189.x · Cited by 93 · see citing works
Recent developments in multiple system atrophy
Wenning, G. K., & Stefanova, N. (2009) · Journal of Neurology · doi:10.1007/s00415-009-5173-8 · Cited by 93 · see citing works
Epidemiology, Diagnosis, and Management of Neurogenic Orthostatic Hypotension
Palma, J., & Kaufmann, H. (2017) · Movement Disorders Clinical Practice · doi:10.1002/mdc3.12478 · Cited by 90 · see citing works
Juraschek, S. P., Daya, N. R., Appel, L. J., Miller, E. R., McEvoy, J. W., Matsushita, K., Ballantyne, C. M., & Selvin, E. (2018) · Journal of the American Heart Association · doi:10.1161/jaha.118.008884 · Cited by 90 · see citing works
“Moreover, the mainstays of OH treatment focus on BP augmentation and stabilization and include increased salt and fluid intake,(43) deescalation of antihypertensive medications,(44) and mineralocorticoid administration.(45,46) These could have adverse health implications if the cause of OH is CVD.”
BackgroundSaklani, P., Krahn, A. D., & Klein, G. J. (2013) · Circulation · doi:10.1161/circulationaha.112.138396 · Cited by 89 · see citing works
Disorders of the Autonomic Nervous System
Chelimsky, T. C., Robertson, D. M., & Chelimsky, G. G. (2012) · Elsevier eBooks · doi:10.1016/b978-1-4377-0434-1.00102-x · Cited by 87 · see citing works
Meißner, K., Distel, H., & Mitzdorf, U. (2007) · BMC Medicine · doi:10.1186/1741-7015-5-3 · Cited by 86 · see citing works
“In total, 34 trials [8-41] investigating chronic stable clinical conditions and reporting on at least one peripheral outcome”
BackgroundManagement of supine hypertension in patients with neurogenic orthostatic hypotension
Jordan, J., Fanciulli, A., Tank, J., Buonaura, G. C., Cheshire, W. P., Cortelli, P., Eschlboeck, S., Grassi, G. M., Hilz, M. J., Kaufmann, H., et al. (2019) · Journal of Hypertension · doi:10.1097/hjh.0000000000002078 · Cited by 88 · see citing works
Cardiac Autonomic Neuropathy in Type 1 and 2 Diabetes: Epidemiology, Pathophysiology, and Management
Williams, S., Raheim, S. A., Khan, M. I., Rubab, U., Kanagala, P., Zhao, S. S., Worthington, A., Brown, E. E., & Alam, U. (2022) · Clinical Therapeutics · doi:10.1016/j.clinthera.2022.09.002 · Cited by 94 · see citing works
Appenrodt, B., Wolf, A., Grünhage, F., et al. (2008) · Liver International · doi:10.1111/j.1478-3231.2008.01734.x · Cited by 83 · see citing works
Kalambokis, G. N., FOTOPOULOS, A. D., Economou, M., et al. (2006) · Journal of Hepatology · doi:10.1016/j.jhep.2006.09.012 · Cited by 82 · see citing works
Mukai, S., & Lipsitz, L. A. (2002) · Clinics in Geriatric Medicine · doi:10.1016/s0749-0690(02)00008-3 · Cited by 81 · see citing works
Feasibility, Utility, and Safety of Midodrine During Recovery Phase From Septic Shock
Whitson, M. R., Mo, E., Nabi, T., et al. (2016) · CHEST Journal · doi:10.1016/j.chest.2016.02.657 · Cited by 80 · see citing works
Chen, S., Chan, P., Sun, S., Chen, H., Zhang, B., Le, W., Liu, C., Peng, G., Tang, B., Wang, L., et al. (2016) · Translational Neurodegeneration · doi:10.1186/s40035-016-0059-z · Cited by 77 · see citing works
Transthyretin Cardiac Amyloidoses in Older North Americans
Dharmarajan, K., & Maurer, M. S. (2012) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2011.03868.x · Cited by 79 · see citing works
Ross, A. J., Ocon, A. J., Medow, M. S., & Stewart, J. M. (2014) · Clinical Science · doi:10.1042/cs20130222 · Cited by 78 · see citing works
“Supine hypertension is a common side effect of midodrine in other forms of OI [22], but was not experienced by any of our POTS subjects of either subtype.”
BackgroundAutonomic nervous system dysfunction in Parkinson’s disease
Zesiewicz, T. A., Baker, M. J., Wahba, M. N., & Hauser, R. A. (2003) · Current Treatment Options in Neurology · doi:10.1007/s11940-003-0005-0 · Cited by 78 · see citing works
Raj, S. R., & Coffin, S. T. (2013) · Progress in Cardiovascular Diseases · doi:10.1016/j.pcad.2012.11.004 · Cited by 79 · see citing works
Juraschek, S. P., Cortez, M. M., Flack, J. M., Ghazi, L., Kenny, R. A., Rahman, M., Spikes, T. A., Shibao, C. A., & Biaggioni, I. (2024) · Hypertension · doi:10.1161/hyp.0000000000000236 · Cited by 80 · see citing works
“These patients are characterized as having hypertension but have periods of often symptomatic drops in BP. Common but often underrecognized examples are postprandial hypotension and postexercise hypotension (see Supplemental Material SM1 for details).”
BackgroundInfluentialMidodrine for Orthostatic Hypotension: A Systematic Review and Meta-Analysis of Clinical Trials
Parsaik, A. K., Singh, B., Altayar, O., Mascarenhas, S. S., Singh, S. K., Erwin, P. J., & Murad, M. H. (2013) · Journal of General Internal Medicine · doi:10.1007/s11606-013-2520-3 · Cited by 73 · see citing works
“study, 23 (14 %) patients dropped out due to different adverse events such as supine hypertension, pilomotor reactions, urinary urgency and retention.(17) Wright et al.”
BackgroundMethodTreatment of Orthostatic Hypotension with Midodrine and Octreotide1
Hoeldtke, R. D., Horvath, G. G., Bryner, K. D., & Hobbs, G. R. (1998) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.83.2.4534 · Cited by 76 · see citing works
Multiple system atrophy: An update
Wenning, G. K., Geser, F., Stampfer‐Kountchev, M., & Tison, F. (2003) · Movement Disorders · doi:10.1002/mds.10561 · Cited by 71 · see citing works
Grubb, B. P., KOSINSKI, D. J., & Kanjwal, Y. (2003) · Pacing and Clinical Electrophysiology · doi:10.1046/j.1460-9592.2003.t01-1-00155.x · Cited by 69 · see citing works
Santer, P., Anstey, M., Patrocínio, M. D., Wibrow, B. A., Teja, B. J., Shay, D., Shaefi, S., Parsons, C. S., Houle, T. T., Eikermann, M., et al. (2020) · Intensive Care Medicine · doi:10.1007/s00134-020-06216-x · Cited by 69 · see citing works
Traon, A. P., Amarenco, G., Duerr, S., Kaufmann, H., Lahrmann, H., Shaftman, S. R., Tison, F., Wenning, G. K., Goetz, C. G., Poewe, W. H., et al. (2011) · Movement Disorders · doi:10.1002/mds.23742 · Cited by 68 · see citing works
Smith, W. B., Wan, H., Much, D. R., Robinson, A., & Martin, P. T. (2016) · Clinical Autonomic Research · doi:10.1007/s10286-016-0363-9 · Cited by 67 · see citing works
The patient with supine hypertension and orthostatic hypotension: a clinical dilemma
Naschitz, J. E., Slobodin, G., Elias, N., & Rosner, I. (2006) · Postgraduate Medical Journal · doi:10.1136/pgmj.2005.037457 · Cited by 69 · see citing works
What is the minimum duration of head-up tilt necessary to detect orthostatic hypotension?
Gehrking, J. A., Hines, S. M., Benrud‐Larson, L. M., et al. (2005) · Clinical Autonomic Research · doi:10.1007/s10286-005-0246-y · Cited by 67 · see citing works
Self-citationWood, L. D. (2010) · Drugs & Aging · doi:10.2165/11318330-000000000-00000 · Cited by 68 · see citing works
Multiple system atrophy of the cerebellar type: Clinical state of the art
Lin, D. J., Hermann, K. L., & Schmahmann, J. D. (2014) · Movement Disorders · doi:10.1002/mds.25847 · Cited by 66 · see citing works
Bril, V., Breiner, A., Perkins, B. A., & Zochodne, D. W. (2018) · Canadian Journal of Diabetes · doi:10.1016/j.jcjd.2017.10.028 · Cited by 67 · see citing works
Prajjwal, P., Sanga, H. S. F., Acharya, K., Tango, T., John, J., Rodriguez, R. S. C., Marsool, M. D. M., Sulaimanov, M., Ahmed, A., & Hussin, O. A. (2023) · Annals of Medicine and Surgery · doi:10.1097/ms9.0000000000001142 · Cited by 70 · see citing works
Traon, A. P., Piedvache, A., Perez‐Lloret, S., Buonaura, G. C., Cock, V. C. D., Colosimo, C., Cortelli, P., Debs, R., Duerr, S., Fanciulli, A., et al. (2015) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp-2014-309999 · Cited by 64 · see citing works
Levine, A. R., Meyer, M. J., Bittner, E. A., Berg, S. M., Kalman, R., Stanislaus, A. B., Ryan, C., Ball, S. A., & Eikermann, M. (2013) · Journal of Critical Care · doi:10.1016/j.jcrc.2013.05.021 · Cited by 64 · see citing works
Efficacy and safety of midodrine hydrochloride in patients with refractory vasovagal syncope
Samniah, N., Sakaguchi, S., Lurie, K. G., Iskos, D., & Benditt, D. G. (2001) · The American Journal of Cardiology · doi:10.1016/s0002-9149(01)01594-6 · Cited by 61 · see citing works
Orthostatic hypotension: managing a difficult problem
Jones, P. K., Shaw, B. H., & Raj, S. R. (2015) · Expert Review of Cardiovascular Therapy · doi:10.1586/14779072.2015.1095090 · Cited by 61 · see citing works
“Midodrine has been shown to significantly increase standing blood pressures while decreasing symptoms of orthostatic intolerance [38,57,58].”
BackgroundPharmacologic options available to treat symptomatic intradialytic hypotension
Perazella, M. A. (2001) · American Journal of Kidney Diseases · doi:10.1053/ajkd.2001.28092 · Cited by 60 · see citing works
Khan, M. F., & Falk, R. H. (2001) · Postgraduate Medical Journal · doi:10.1136/pmj.77.913.686 · Cited by 59 · see citing works
Treatment of postural tachycardia syndrome: a comparison of octreotide and midodrine
Hoeldtke, R. D., Bryner, K. D., Hoeldtke, M. E., & Hobbs, G. (2006) · Clinical Autonomic Research · doi:10.1007/s10286-006-0373-0 · Cited by 57 · see citing works
“Midodrine is a peripheral vasoconstrictor [9], whereas octreotide mainly affects the splanchnic circulation [6].”
BackgroundThe Management of Orthostatic Hypotension in Parkinson’s Disease
Sánchez‐Ferro, Á., Benito‐León, J., & Gómez‐Esteban, J. C. (2013) · Frontiers in Neurology · doi:10.3389/fneur.2013.00064 · Cited by 59 · see citing works
Non-motor symptoms: Identification and management
Muzerengi, S., Contrafatto, D., & Chaudhuri, К. R. (2007) · Parkinsonism & Related Disorders · doi:10.1016/s1353-8020(08)70048-8 · Cited by 58 · see citing works
- Authors
- Low, P. A.
- Corresponding author
- Low, Phillip A.
- ORCID
- Low, Phillip A.
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 1997-04-02
- Volume
- 277
- Issue
- 13
- Pages
- 1046
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- OpenAlex
- W4294549596
- Cited by
- 425
- References
- 0
- Citations by year
- 2026: 9 · 2025: 17 · 2024: 11 · 2023: 10 · 2022: 13 · 2021: 16 · 2020: 23 · 2019: 18 · 2018: 15 · 2017: 22 · 2016: 20 · 2015: 25 · 2014: 27 · 2013: 18 · 2012: 20
- FWCI
- 8.21
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- JAMA (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Keywords
- midodrine, neurogenic orthostatic hypotension, alpha-adrenergic agonists, blood pressure, lightheadedness, symptom relief, vascular tone, adverse effects, urinary retention, supine hypertension
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