Fluoxetine vs. propranolol in the treatment of vasovagal syncope: a prospective, randomized, placebo-controlled study

Theodorakis, George; Leftheriotis, Dionyssios; Livanis, Efthimios; Flevari, Panagiota; Karabela, Georgia; Aggelopoulou, Nikolitsa; Kremastinos, Dimitrios Th.

doi:10.1093/europace/euj041

Cited by 74 publications

(28 citation statements)

References 27 publications

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“…In two randomized controlled trials, treatment with selective serotonin reuptake inhibitors was compared with placebo treatment [10,27]. Although no significant differences were found with respect to the syncope burden and quality of life, recurrence of syncope during follow-up was lower during treatment with selective serotonin reuptake inhibitors than during placebo treatment [10,27].…”

Section: Main Findingsmentioning

confidence: 99%

Association between psychological complaints and recurrence of vasovagal syncope

et al. 2011

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Section: Main Findingsmentioning

confidence: 99%

Association between psychological complaints and recurrence of vasovagal syncope

et al. 2011

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“…It may also prove efficient in patients with concomitant VVS, as it is the case with pharmacotherapy. The experience of psychotherapy in patients with recurrent VVS is also limited and mainly concerns desensitization or cognitive behavioral therapy [44, 45]. Although a variety of therapeutic means have been used in VVS, not one of them was effective enough to be widely applied.…”

Section: Discussionmentioning

confidence: 99%

Minor Psychiatric Disorders and Syncope: The Role of Psychopathology in the Expression of Vasovagal Reflex

Leftheriotis

Michopoulos²,

Flevari³

et al. 2008

Psychother Psychosom

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Background: A high prevalence of minor psychiatric disorders (MPDs) has been reported in patients with vasovagal syncope (VVS). However, the relationship between the psychiatric substrate and syncope remains unclear. Methods: In order to test the hypothesis that MPDs may predispose to VVS, we assessed the prevalence of syncope, the response to head-up tilt test (HUTT) and the efficacy of psychiatric drug treatment in reducing syncopal episodes, in patients with recently diagnosed MPDs. The response to HUTT was compared with that in an equal number of matched (a) patients with VVS and (b) healthy controls. Results: A high rate of patients with MPDs (58%) had a positive HUTT. Additionally, 45% had a history of syncope; among them, the rate of positive HUTT was identical to that in the VVS group (83%). Following psychiatric drug treatment, the number of patients with syncope decreased in the MPD group (6/67 from 30/67, p < 0.01). Psychiatric symptoms and quality of life were also improved. The number of syncopal spells decreased equally in the MPD and VVS groups (0.6 ± 0.5 from 2.5 ± 1.4, p < 0.01, and 0.7 ± 0.5 from 2.7 ± 1.3, p < 0.01, respectively). Conclusion: A high proportion of patients with MPDs experience syncope, associated with a high rate of positive HUTT, comparable to that observed in VVS. Psychiatric treatment results in the improvement of syncopal and psychiatric symptoms. These findings suggest involvement of co-occurring MPDs in the pathogenesis of VVS. Therefore, the diagnosis and treatment of MPDs, when present, may be crucial for the effective therapy of vasovagal syndrome.

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“…The SSRIs also merit revisiting, particularly in conjunction with more detailed QOL and psychological assessment. The preliminary studies had insufficient sample size to demonstrate efficacy [41], but consistent direction and magnitude of effect in meta-analysis.…”

Section: Direction For Clinical Services and Researchmentioning

confidence: 97%

Does any therapy really work for neurocardiogenic syncope?

Hawkins

Krahn

2014

Cardiol J

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Fluoxetine vs. propranolol in the treatment of vasovagal syncope: a prospective, randomized, placebo-controlled study

Abstract: Fluoxetine seems to be equivalent to propranolol and placebo in the treatment of VVS. However, it improves patients' well-being and might be more effective in reducing presyncopes and total vasovagal events in some patients with recurrent VVS.

Cited by 74 publications

References 27 publications

Association between psychological complaints and recurrence of vasovagal syncope

Association between psychological complaints and recurrence of vasovagal syncope

Minor Psychiatric Disorders and Syncope: The Role of Psychopathology in the Expression of Vasovagal Reflex

Does any therapy really work for neurocardiogenic syncope?

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