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Therapeutics
Paroxetine reduced recurrent syncope in patients who were resistant to or intolerant of other drug therapy

https://doi.org/10.1136/ebm.4.6.170

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    Di Girolamo E, Di Iorio C, Sabatini P, et al. Effects of paroxetine hydrochloride, a selective serotonin reuptake inhibitor, on refractory vasovagal syncope: a randomized, double-blind, placebo-controlled study. J Am Coll Cardiol. 1999 Apr;33:1227-30.

    Question

    In patients with recurrent vasovagal syncope who are resistant to or intolerant of traditional drug therapy, does paroxetine hydrochloride, a selective serotonin-reuptake inhibitor (SSRI), prevent syncope?

    Design

    Randomized, double-blind, placebo-controlled trial with mean follow-up of 25 months.

    Setting

    A university hospital in Italy.

    Patients

    68 consecutive patients (mean age 45 y, 62% women) with refractory syncope and a positive nitrate-potentiated tilt-table test result. The cause of the syncope was not known despite intensive testing and was presumed to be vasovagal; all patients had received conventional medications, which were ineffective or not tolerated. Patients with major endog enous depression or panic disorder were excluded. Follow-up was 100%.

    Intervention

    34 patients were allocated to oral paroxetine, 20 mg/d, and 34 patients were …

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