nanonug
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1. Am J Ther. 2012 Jan;19(1):2-6.
Use of methylphenidate in the treatment of patients suffering from refractory
postural tachycardia syndrome.
Kanjwal K, Saeed B, Karabin B, Kanjwal Y, Grubb BP.
Section of Electrophysiology, Division of Cardiology, Department of Medicine,
University of Toledo Medical Center, Toledo, OH 43614, USA.
Methylphenidate has been shown to be an effective therapy in patients with
refractory neurocardiogenic syncope. However, the role of methylphenidate in
patients suffering from postural orthostatic tachycardia (POTS) has not been
reported. The study was approved by the institutional review board. A
retrospective nonrandomized analysis was preformed on 24 patients evaluated at
our autonomic center for POTS from 2003 to 2010. The diagnosis of POTS was based
on patient history, physical examination, and response to head up tilt table
testing. The mean follow-up period was 9 ± 3 months. The patients were included
in the current study if they had a diagnosis of POTS with severe symptoms of
orthostatic intolerance and were refractory to the commonly used medications. All
of these patients were started on methylphenidate and the response to therapy was
considered successful if it provided symptomatic relief. Twenty-four patients
(age 28 ± 12, 20 women) met inclusion criterion for this study. The response to
treatment was assed subjectively in each patient and was collected in a
retrospective fashion from patient charts and physician communications. Four
patients reported side effects in the form of nausea and 2 ultimately had to
discontinue the treatment. Another 4 patients had a follow-up of less than 6
months. Thus, only 18 patients who received methylphenidate completed the
follow-up of 6 months. Out of these 18 patients, 14 (77%) patients reported
marked improvement in their symptoms. Nine out of 12 patients who had recurrent
episodes of syncope reported no syncope at 6 months of follow-up. Fourteen (77%)
patients reported marked improvement in their symptoms of fatigue and presyncope.
Four patients continue to have symptoms of orthostatic intolerance and 3
continued to have recurrent episodes of syncope. Methylphenidate may be
beneficial in patients with otherwise refractory postural tachycardia syndrome.
PMID: 20460983
Use of methylphenidate in the treatment of patients suffering from refractory
postural tachycardia syndrome.
Kanjwal K, Saeed B, Karabin B, Kanjwal Y, Grubb BP.
Section of Electrophysiology, Division of Cardiology, Department of Medicine,
University of Toledo Medical Center, Toledo, OH 43614, USA.
Methylphenidate has been shown to be an effective therapy in patients with
refractory neurocardiogenic syncope. However, the role of methylphenidate in
patients suffering from postural orthostatic tachycardia (POTS) has not been
reported. The study was approved by the institutional review board. A
retrospective nonrandomized analysis was preformed on 24 patients evaluated at
our autonomic center for POTS from 2003 to 2010. The diagnosis of POTS was based
on patient history, physical examination, and response to head up tilt table
testing. The mean follow-up period was 9 ± 3 months. The patients were included
in the current study if they had a diagnosis of POTS with severe symptoms of
orthostatic intolerance and were refractory to the commonly used medications. All
of these patients were started on methylphenidate and the response to therapy was
considered successful if it provided symptomatic relief. Twenty-four patients
(age 28 ± 12, 20 women) met inclusion criterion for this study. The response to
treatment was assed subjectively in each patient and was collected in a
retrospective fashion from patient charts and physician communications. Four
patients reported side effects in the form of nausea and 2 ultimately had to
discontinue the treatment. Another 4 patients had a follow-up of less than 6
months. Thus, only 18 patients who received methylphenidate completed the
follow-up of 6 months. Out of these 18 patients, 14 (77%) patients reported
marked improvement in their symptoms. Nine out of 12 patients who had recurrent
episodes of syncope reported no syncope at 6 months of follow-up. Fourteen (77%)
patients reported marked improvement in their symptoms of fatigue and presyncope.
Four patients continue to have symptoms of orthostatic intolerance and 3
continued to have recurrent episodes of syncope. Methylphenidate may be
beneficial in patients with otherwise refractory postural tachycardia syndrome.
PMID: 20460983