Melatonin reduces tachycardia in postural tachycardia syndrome: a randomized, crossover trial
Open accessAbstract
BACKGROUND: Postural tachycardia syndrome (POTS) induces disabling chronic orthostatic intolerance with an excessive increase in heart rate (HR) upon standing, and many POTS patients have a hyperadrenergic state. Medications that restrain HR are a promising approach to this problem. OBJECTIVE: We tested the hypothesis that melatonin will attenuate the tachycardia and improve symptom burden in patients with POTS. METHODS: Patients with POTS (n = 78) underwent acute drug trials with melatonin 3 mg orally and placebo, on separate mornings, in a randomized crossover design. Blood pressure, HR, and symptoms were assessed while seated and after standing for up to 10 min prior to, and hourly for 4 h following study drug administration. RESULTS: The reduction in standing HR was significantly greater 2 h after melatonin compared with placebo (P = 0.017). There was no significant difference in the reduction of systolic blood pressure between melatonin and placebo, either with standing or while seated. The symptom burden was not improved with melatonin compared with placebo. CONCLUSION: Oral melatonin produced a modest decrease in standing tachycardia in POTS. Further research is needed to determine the effects of regular night-time use of this medication in POTS.
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Melatonin reduced tachycardia but did not improve symptom burden compared to placebo.
“Melatonin reduced tachycardia but did not improve symptom burden compared to placebo (Green et al., 2014”
From Self-reported symptom burden in postural orthostatic tachycardia syndrome (POTS): A narrative review of observational and interventional studies (2023) · cites this paper as Green et al., 2014
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“GREEN ET AL., 2014 Reduce the hyperadrenerg ic state, reduce tachycardia USA 78 Melatonin randomize d, crossover design on two separate mornings placebo VOSS Symptom burden was not improved with melatonin compared with placebo, there was a modest decrease in standing tachycardia.”
- Authors
- Green, E. A., Black, B. K., Biaggioni, I., Paranjape, S. Y., Bagai, K., Shibao, C., Okoye, M. C., Dupont, W. D., Robertson, D., & Raj, S. R.
- Affiliations
- Vanderbilt University (US)
- Corresponding author
- Raj, Satish R.
- Venue
- Cardiovascular Therapeutics
- Publisher
- Wiley
- Published
- 2014-04-23
- Volume
- 32
- Issue
- 3
- Pages
- 105-112
- ISSN
- 1755-5914 (ISSN-L)
- 1755-5922
- PMC
- PMC3999238
- OpenAlex
- W2124493903
- Cited by
- 33
- References
- 9
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 3 · 2023: 2 · 2022: 2 · 2021: 4 · 2020: 8 · 2019: 1 · 2018: 6 · 2017: 1 · 2016: 2
- FWCI
- 0.99
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Cardiovascular Therapeutics (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Pharmaceutical Research and Manufacturers of America Foundation
- Vanderbilt University
- National Institutes of Health (UL1TR000445)
- National Heart, Lung, and Blood Institute (K23HL103976, P01HL056693, R01HL102387, P01 HL-56693)
- National Institute of Neurological Disorders and Stroke (U54NS065736)
- NIH Clinical Center
- National Center for Advancing Translational Sciences
- 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 › Gastroenterology › Gastrointestinal motility and disorders
- Keywords
- postural orthostatic tachycardia syndrome, melatonin, orthostatic intolerance, heart rate, blood pressure, symptom burden, hyperadrenergic state
- MeSH terms
- Administration, Oral, Adult, Anti-Arrhythmia Agents, Blood Pressure, Drug Administration Schedule, Female, Heart Rate, Humans, Male, Melatonin, Norepinephrine, Sympathetic Nervous System, Tennessee, Time Factors, Treatment Outcome, Cross-Over Studies, Postural Orthostatic Tachycardia Syndrome, Young Adult
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