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TITLE:
The role of serotonin re-uptake inhibitors in
preventing recurrent unexplained childhood syncope -- a preliminary report.
AUTHOR:
Lenk M; Alehan D; Ozme S; Celiker A; Ozer S
AUTHOR AFFILIATION:
Department of Paediatrics, Hacettepe University,
Faculty of Medicine, Ankara, Turkey.
SOURCE:
Eur J Pediatr 1997 Oct;156(10):747-50
NLM CIT. ID:
98030342
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.
MAIN MESH SUBJECTS:
Serotonin Uptake Inhibitors/ADVERSE
EFFECTS/*THERAPEUTIC USE
Syncope, Vasovagal/ETIOLOGY/*PREVENTION & CONTROL
1-Naphthylamine/*ANALOGS & DERIVATIVES/ADVERSE EFFECTS/ THERAPEUTIC USE
ADDITIONAL MESH SUBJECTS:
Adolescence
Blood Pressure/DRUG EFFECTS
Child
Female
Heart Rate/DRUG EFFECTS
Human
Male
Recurrence
Tilt-Table Test
Treatment Outcome
When my office
lease expired at the end of 2004, I decided to turn it into a
"sabbatical" from my private practice. Many years ago, in my
grandfather's 89th year of life, he told me, "John, it is important
to smell the roses while you can still smell them." His life
gave living a very good reputation. It is also true that the
pursuit of that philosophy required my grandfather to to re-open his
assay office/ore market in Wickenburg, Arizona as a 75-year-old because
he had run a little short of retirement money. Thus, if blessed with his
luck and health, I'll be back.. --jjh
