Midodrine and droxidopa possess the most evidence with respect to increasing blood pressure and alleviating symptoms. Pyridostigmine and fludrocortisone can be used in patients who fail to respond to these agents. Emerging evidence with low-dose atomoxetine is promising, especially in those with central autonomic failure, and may prove to be a viable alternative treatment option. Data surrounding other therapies such as sympathomimetic agents or octreotide are minimal. Medication management of primary OH should be guided by patient-specific factors, such as tolerability, adverse effects, and drug-drug and drug-disease interactions.

Students receiving additional preparation prior to interviews when seeking postdoctoral training were significantly more likely to obtain a residency position. In academic settings with limited resources, mock interviews may be preferred over comprehensive preparatory courses.

Purpose The purpose of this study was to determine antidepressant use among Mexican Americans (MA) and non-Hispanic (NH) blacks and whites with type 2 diabetes and depressive symptoms. Methods A secondary data analysis based on National Health and Nutrition Examination Survey (NHANES) 2005-2012 cohort data included 560 noninstitutionalized civilian MA, NH black, and NH white adults with type 2 diabetes and depressive symptoms. Unadjusted and adjusted 2-way ANOVA models evaluated whether there was a difference in the use of antidepressants by depressive symptom level across race/ethnic group. Results Whites were more likely than blacks and MA to be on antidepressant treatment (whites: 41.7%, blacks: 27.1%, MA: 24.2%) and on serotonin-norepinephrine reuptake inhibitors (SNRI) (whites: 8.1%, blacks: 2.9%, MA: 2.4%). However, there was no difference in the use of other drug classes or antidepressant use by depressive symptom level across racial/ethnic group. Followed by tricyclic antidepressants (TCA), selective serotonin reuptake inhibitors (SSRI) were the most commonly used drug class overall. Approximately 30% of subjects were on antidepressants and among those, 80% were on one antidepressant, all others on 2 or more. Conclusions Racial/ethnic differences were observed in the use of antidepressant treatment but not when depressive symptom levels were incorporated in the analyses. Further studies on the effectiveness of different antidepressants in diabetes outcomes minorities are needed.

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