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Use of octreotide in the treatment of refractory orthostatic intolerance.
Am J Ther. 2012 Jan; 19(1):7-10.AJ

Abstract

There have been reports on the use of octreotide in patients with orthostatic hypotension, postural tachycardia syndrome, and orthostatic syncope. However, there are little if any data on the use of octreotide in patients who have failed multiple other medications. This study was a retrospective chart analysis and was approved by our Institutional Review Board. A total of 12 patients were identified for inclusion in this study. The diagnosis of orthostatic intolerance was based on patient history, physical examination, and response to Head Up Tilt Table testing. These patients had failed multiple medications and were ultimately treated with octreotide. In a retrospective chart review, we collected data, including demographic information, presenting symptoms, laboratory data, tilt-table response, standing heart rate, standing blood pressure before and after treatment (wherever available), and treatment outcomes. Twelve patients aged 33 ± 18 years, eight (66.7%) females, were found to have symptoms of refractory orthostatic intolerance and failed multiple regimens of medication and were ultimately treated with octreotide administration. Five patients (41.7%) had demonstrated a postural tachycardia syndrome pattern, five (41.7%) a neurocardiogenic, and two (16.6%) a dysautonomic response on a Head Up Tilt Table. Symptoms of syncope and orthostatic palpitations improved in six (50%) of the patients. Standing heart rate was significantly reduced after octreotide administration (80 ± 8 versus 108 ± 13; P < 0.05). The standing systolic blood pressure was increased after octreotide administration (107 ± 26 versus 116 ± 22). Three patients (25%) reported complete elimination of syncope, whereas another three had reduction in the frequency of their syncope. However, symptoms of fatigue improved only in two (29%) of the seven patients. Octreotide may improve symptoms in some patients with refractory orthostatic intolerance.

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Authors+Show Affiliations

Kanjwal K
Department of Medicine, Division of Cardiology, Section of Electrophysiology, The 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

AdolescentAdultBlood PressureFatigueFemaleHeart RateHumansMaleMiddle AgedOctreotideOrthostatic IntolerancePostural Orthostatic Tachycardia SyndromeRetrospective StudiesSyncopeSyncope, VasovagalTilt-Table TestTreatment OutcomeYoung Adult

Pub Type(s)

Journal Article

Language

eng

PubMed ID

20535001

Citation

Kanjwal, Khalil, et al. "Use of Octreotide in the Treatment of Refractory Orthostatic Intolerance." American Journal of Therapeutics, vol. 19, no. 1, 2012, pp. 7-10.
Kanjwal K, Saeed B, Karabin B, et al. Use of octreotide in the treatment of refractory orthostatic intolerance. Am J Ther. 2012;19(1):7-10.
Kanjwal, K., Saeed, B., Karabin, B., Kanjwal, Y., & Grubb, B. P. (2012). Use of octreotide in the treatment of refractory orthostatic intolerance. American Journal of Therapeutics, 19(1), 7-10. https://doi.org/10.1097/MJT.0b013e3181e28156
Kanjwal K, et al. Use of Octreotide in the Treatment of Refractory Orthostatic Intolerance. Am J Ther. 2012;19(1):7-10. PubMed PMID: 20535001.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Use of octreotide in the treatment of refractory orthostatic intolerance. AU - Kanjwal,Khalil, AU - Saeed,Bilal, AU - Karabin,Beverly, AU - Kanjwal,Yousuf, AU - Grubb,Blair P, PY - 2010/6/11/entrez PY - 2010/6/11/pubmed PY - 2012/5/2/medline SP - 7 EP - 10 JF - American journal of therapeutics JO - Am J Ther VL - 19 IS - 1 N2 - There have been reports on the use of octreotide in patients with orthostatic hypotension, postural tachycardia syndrome, and orthostatic syncope. However, there are little if any data on the use of octreotide in patients who have failed multiple other medications. This study was a retrospective chart analysis and was approved by our Institutional Review Board. A total of 12 patients were identified for inclusion in this study. The diagnosis of orthostatic intolerance was based on patient history, physical examination, and response to Head Up Tilt Table testing. These patients had failed multiple medications and were ultimately treated with octreotide. In a retrospective chart review, we collected data, including demographic information, presenting symptoms, laboratory data, tilt-table response, standing heart rate, standing blood pressure before and after treatment (wherever available), and treatment outcomes. Twelve patients aged 33 ± 18 years, eight (66.7%) females, were found to have symptoms of refractory orthostatic intolerance and failed multiple regimens of medication and were ultimately treated with octreotide administration. Five patients (41.7%) had demonstrated a postural tachycardia syndrome pattern, five (41.7%) a neurocardiogenic, and two (16.6%) a dysautonomic response on a Head Up Tilt Table. Symptoms of syncope and orthostatic palpitations improved in six (50%) of the patients. Standing heart rate was significantly reduced after octreotide administration (80 ± 8 versus 108 ± 13; P < 0.05). The standing systolic blood pressure was increased after octreotide administration (107 ± 26 versus 116 ± 22). Three patients (25%) reported complete elimination of syncope, whereas another three had reduction in the frequency of their syncope. However, symptoms of fatigue improved only in two (29%) of the seven patients. Octreotide may improve symptoms in some patients with refractory orthostatic intolerance. SN - 1536-3686 UR - https://www.unboundmedicine.com/medline/citation/20535001/Use_of_octreotide_in_the_treatment_of_refractory_orthostatic_intolerance_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&amp;PAGE=linkout&amp;SEARCH=20535001.ui DB - PRIME DP - Unbound Medicine ER -