L-dihydroxyphenylserine (Droxidopa): a new therapy for neurogenic orthostatic hypotension: The US experience
Abstract
Neurogenic orthostatic hypotension results from failure to release norepinephrine, the neurotransmitter of sympathetic postganglionic neurons, appropriately upon standing. In double blind, cross over, placebo controlled trials, administration of droxidopa, a synthetic amino acid that is decarboxylated to norepinephrine by the enzyme L: -aromatic amino acid decarboxylase increases standing blood pressure, ameliorates symptoms of orthostatic hypotension and improves standing ability in patients with neurogenic orthostatic hypotension due to degenerative autonomic disorders. The pressor effect results from conversion of droxidopa to norepinephrine outside the central nervous system both in neural and non-neural tissue. This mechanism of action makes droxidopa effective in patients with central and peripheral autonomic disorders.
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Droxidopa has been used off-label empirically in severe POTS.
“Drug has been empirically used offlabel in severe POTS.”
From Postural orthostatic tachycardia syndrome: clinical presentation, aetiology and management (2019) · cites this paper as [96]
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Postural orthostatic tachycardia syndrome: clinical presentation, aetiology and management
Fedorowski, A. (2019) · Journal of Internal Medicine · doi:10.1111/joim.12852 · Cited by 352 · see citing works
- Authors
- Kaufmann, H.
- Affiliations
- New York University (US)
- Corresponding author
- Kaufmann, Horacio
- ORCID
- Kaufmann, Horacio
- Venue
- Clinical Autonomic Research
- Published
- 2008-03
- Volume
- 18
- Issue
- S1
- Pages
- 19-24
- ISSN
- 0959-9851 (ISSN-L)
- 1619-1560
- OpenAlex
- W1747655459
- Cited by
- 80
- References
- 18
- Citations by year
- 2025: 3 · 2024: 2 · 2023: 4 · 2022: 3 · 2021: 6 · 2020: 2 · 2019: 4 · 2018: 2 · 2017: 4 · 2016: 3 · 2015: 12 · 2014: 9 · 2013: 14 · 2012: 3
- FWCI
- 2.46
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Clinical Autonomic Research (publishedVersion)
- PubMed (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 › Neurology › Parkinson's Disease Mechanisms and Treatments
- Keywords
- droxidopa, L-DOPA, neurogenic orthostatic hypotension, norepinephrine, aromatic L-amino acid decarboxylase, autonomic dysfunction, blood pressure, pharmacotherapy
- MeSH terms
- Autonomic Nervous System Diseases, Blood Pressure, Carbidopa, Central Nervous System Diseases, Humans, Hypotension, Orthostatic, Levodopa, Norepinephrine, United States, Droxidopa, Controlled Clinical Trials as Topic, Multiple System Atrophy
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