Pindolol in Orthostatic Hypotension, Possible Therapy?

Frewin, D. B.; Pp, Leonello; Rk, Penhall; Hughes, Lauren; Pe, Harding

doi:10.5694/j.1326-5377.1980.tb134689.x

Cited by 15 publications

(3 citation statements)

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“…This is called intrinsic sympathomimetic activity (ISA) and is a characteristic feature of Pindolol [13]. There have been some reports of a beneficial effect of Pindolol (15 mg/day) in the treatment of orthostatic hypotension in diabetic patients [5][6][7][8][9]. This effect is hypothetically explained by two mechanisms.…”

Section: Discussionmentioning

confidence: 99%

“…The patients in the present study all had rather weak symptoms with rather high standing blood pressures compared to the patients reported where Pindolol had a beneficial effect. Most of these patients had signs of worse sympathetic damage with fainting on standing and upright systolic blood pressures below 100 mm Hg [5][6][7][8][9]. In clinical practice these patients are rare.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, the dopaminergic antagonist metoclopramide and the prostaglandin synthesis inhibitor indomethacin have been recommended [3,4]. It has been suggested in uncontrolled studies that Pindo-1ol, a beta-adrenoceptor antagonist with a high degree of intrinsic sympathomimetic activity could be therapeutically effective in patients with severe orthostatic hypotension [5][6][7][8]. The aim of the present study was to evaluate the effect of Pindolol in a double-blind randomised cross-over study in Type 1 (insulin-dependent) diabetic patients with autonomic failure and symptomatic orthostatic hypotension.…”

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confidence: 99%

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No effect of Pindolol on postural hypotension in Type 1 (insulin-dependent) diabetic patients with autonomic neuropathy. A randomised double-blind controlled study

Dejgård¹,

Hilsted

1988

Diabetologia

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Orthostatic hypotension is one of the most troublesome symptoms in diabetic autonomic neuropathy. Some reports have suggested Pindolol -a beta-adrenoceptor antagonist with intrinsic sympathomimetic activity -to be effective in the treatment of this condition. In order to elucidate the value of this therapy we performed a double-blind placebo controlled cross-over study with Pindolol (15 mg/day). Eight Type 1 (insulin-dependent) diabetic patients with autonomic neuropathy and signs and symptoms of orthostatic hypotension (systolic blood pressure decrease greater than 30 mm Hg when standing) participated in the study. Patients were treated for 10 weeks. Clinical examinations were per-formed eve~ fortnight and patients registered postural symptoms twice daily on a visual analog scale. No significant changes were seen in blood pressure recordings, heart-rate or visual analog scale registration during treatment with Pindo-1ol compared to placebo. Our study does not support the suggestion that Pindolol is a valuable drug for treatment of diabetic patients with autonomic neuropathy and postural giddiness.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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No effect of Pindolol on postural hypotension in Type 1 (insulin-dependent) diabetic patients with autonomic neuropathy. A randomised double-blind controlled study

Dejgård¹,

Hilsted

1988

Diabetologia

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Disorders of the autonomic nervous system: Part 2. investigation and treatment

McLeod

Tuck

1987

Annals of Neurology

149

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Autonomic function may be adequately tested with noninvasive tests of sympathetic and parasympathetic pathways, including: the response of blood pressure to change in posture and isometric contraction, heart rate response to standing, variation in heart rate with respiration, Valsalva ratio, sweat tests, and plasma noradrenaline measurements. Abnormal results in two or more of these tests indicate autonomic dysfunction. Intraarterial catheterization and tests of vasomotor function are usually required only in doubtful cases or for research purposes. Treatment of autonomic dysfunction is focused primarily on bladder control and control of orthostatic hypotension. Orthostatic hypotension is best treated with physical measures, pharmacologically with 9-alpha-fluorohydrocortisone and dihydroergotamine mesylate. A number of other agents may be tried but results have been less effective.

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Pindolol: A Review of Its Pharmacology, Pharmacokinetics, Clinical Uses, and Adverse Effects

Golightly¹

1982

Pharmacotherapy

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Pindolol is a new noncardioselective beta adrenergic blocking agent with intrinsic sympathomimetic activity. In the treatment of mild to moderate hypertension, pindolol provides effective control of blood pressure in a large majority of patients when administered alone or, more commonly, when combined with a thiazide diuretic. Pindolol is approximately as effective as propranolol in the therapy of hypertension, but in some crossover trials central nervous system side effects were more frequent with pindolol. A "ceiling effect" may be observed as dosages are titrated upward above approximately 20 to 30 mg per day, such that further blood pressure reductions may not be achievable. Some patients will exhibit a paradoxical increase in blood pressure with an increase in dosage. In patients who respond to modest doses of pindolol, twice or even once daily dosing is often adequate. This prolonged duration of hypotensive activity, while not suggested by the kinetics of this or similar drugs, is probably common to most beta blockers. Investigations in small numbers of patients with angina pectoris have reported variable but generally beneficial results with pindolol.

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Pindolol in Orthostatic Hypotension, Possible Therapy?

Cited by 15 publications

References 0 publications

No effect of Pindolol on postural hypotension in Type 1 (insulin-dependent) diabetic patients with autonomic neuropathy. A randomised double-blind controlled study

No effect of Pindolol on postural hypotension in Type 1 (insulin-dependent) diabetic patients with autonomic neuropathy. A randomised double-blind controlled study

Disorders of the autonomic nervous system: Part 2. investigation and treatment

Pindolol: A Review of Its Pharmacology, Pharmacokinetics, Clinical Uses, and Adverse Effects

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