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Use of methylphenidate in the treatment of patients suffering from refractory postural tachycardia syndrome.
Am J Ther. 2012 Jan; 19(1):2-6.AJ

Abstract

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.

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Authors+Show Affiliations

Kanjwal K
Section of Electrophysiology, Division of Cardiology, Department of Medicine, University of Toledo Medical Center, Toledo, OH 43614, USA.
Saeed B
No affiliation info available
Karabin B
No affiliation info available
Kanjwal Y
No affiliation info available
Grubb BP
No affiliation info available

MeSH

AdolescentAdultCentral Nervous System StimulantsFatigueFemaleFollow-Up StudiesHumansMaleMethylphenidatePostural Orthostatic Tachycardia SyndromeRecurrenceRetrospective StudiesSeverity of Illness IndexSyncopeTreatment OutcomeYoung Adult

Pub Type(s)

Journal Article

Language

eng

PubMed ID

20460983

Citation

Kanjwal, Khalil, et al. "Use of Methylphenidate in the Treatment of Patients Suffering From Refractory Postural Tachycardia Syndrome." American Journal of Therapeutics, vol. 19, no. 1, 2012, pp. 2-6.
Kanjwal K, Saeed B, Karabin B, et al. Use of methylphenidate in the treatment of patients suffering from refractory postural tachycardia syndrome. Am J Ther. 2012;19(1):2-6.
Kanjwal, K., Saeed, B., Karabin, B., Kanjwal, Y., & Grubb, B. P. (2012). Use of methylphenidate in the treatment of patients suffering from refractory postural tachycardia syndrome. American Journal of Therapeutics, 19(1), 2-6. https://doi.org/10.1097/MJT.0b013e3181dd21d2
Kanjwal K, et al. Use of Methylphenidate in the Treatment of Patients Suffering From Refractory Postural Tachycardia Syndrome. Am J Ther. 2012;19(1):2-6. PubMed PMID: 20460983.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Use of methylphenidate in the treatment of patients suffering from refractory postural tachycardia syndrome. AU - Kanjwal,Khalil, AU - Saeed,Bilal, AU - Karabin,Beverly, AU - Kanjwal,Yousuf, AU - Grubb,Blair P, PY - 2010/5/13/entrez PY - 2010/5/13/pubmed PY - 2012/5/2/medline SP - 2 EP - 6 JF - American journal of therapeutics JO - Am J Ther VL - 19 IS - 1 N2 - 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. SN - 1536-3686 UR - https://www.unboundmedicine.com/medline/citation/20460983/Use_of_methylphenidate_in_the_treatment_of_patients_suffering_from_refractory_postural_tachycardia_syndrome_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=20460983.ui DB - PRIME DP - Unbound Medicine ER -