Abstract
To assess the efficacy of a serotonin re-uptake inhibitor, sertraline hydrochloride, in preventing recurrent neurocardiogenic syncope, we studied 15 patients (10 female; mean age 12.9 ± 2 years) with positive head-upright tilt test and resistant to standard pharmacotherapy, atenolol or disopyramide. The patients were given 50 mg oral sertraline hydrochloride daily for 6 weeks. Intolerance to the drug was seen in 3 patients and 2 had syncopal episodes during the therapy. A head-upright tilt table test was then repeated in 10 patients. Six were tilt negative and asymptomatic over a mean follow up period of 7 ± 3 months while four remained tilt positive: two experienced marked hypotension and bradycardia, characterized as mixed type syncope, and two had cardiac asystole, lasting >10 s, during tilting, thereby exhibiting a cardio-inhibitory response.
Conclusion Sertraline hydrochloride may be useful in preventing recurrent neurocardiogenic syncope resistant to standard pharmacotherapy but careful clinical studies are essential before such a treatment strategy can be recommended since serious asystole could develop.
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Received: 25 October 1996 and in revised form: 31 December 1996 / Accepted: 4 February 1997
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Lenk, M., Alehan, D., Özme, Ş. et al. The role of serotonin re-uptake inhibitors in preventing recurrent unexplained childhood syncope – a preliminary report. Eur J Pediatr 156, 747–750 (1997). https://doi.org/10.1007/s004310050704
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DOI: https://doi.org/10.1007/s004310050704