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In a double-blind inter-individual study of 51 patients with abnormal hypotonic orthostatic regulation, the effect of dihydroergotamine (2 mg), etilefrine (20 mg) or their combination (2 mg and 20 mg, respectively) was studied. Blood pressure, heart rate, dicrotic ratio as well as number and severity of symptoms during standardised orthostasis were studied before and after a week on placebo and after one and two weeks of drug administration. Resting blood pressure after treatment with the two drugs combined rose from 111/73 to 120/77 mm Hg, after etilefrine from 114/74 to 122/79 mm Hg, remaining essentially unchanged after dihydroergotamine. Fall in dicrotic ratio, as a measure of change in mean blood pressure, was 10% during the first minute of standing with the combined drugs, 30-35% with each drug separately. Treatment with the combined drugs was also superior when considering systolic blood pressure, pressure amplitude and heart rate. Similarly, the drugs in combination caused the least number and lowest severity of symptoms: side-effects were less common with the combination than with each drug alone.

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