Preliminary Observations on the Effect of Amitriptyline Treatment in Preventing Syncope Recurrence in Patients with Vasovagel Syncope

Authors: Barış Kaya, Ergün¹; Abalı, Gülcan¹; Aytemir, Kudret¹; Köse, Sedat²; Kocabaş, Uğur¹; Tokgözoğlu, Lale¹; Kabakçı, Giray¹; Amasyalı, Basri²; Özkutlu, Hilmi¹; Nazlı, Nasıh¹; Oto, Ali¹

Source: Annals of Noninvasive Electrocardiology, Volume 12, Number 2, April 2007 , pp. 153-157(5)

Publisher: Wiley-Blackwell

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Abstract:

Purpose: Vasovagal syncope is a common and challenging problem that may result in injury and causes susbstantial anxiety among patients and their relatives. However, treatment of vasovagal syncope with standard pharmacologic approaches is not satisfactory. The aim of this study is to investigate the effect of amitriptyline, a tricyclic antidepressant drug, by using its anticholinergic effects in preventing syncopal episodes in patients with vasovagal syncope.

Methods: In this study, 74 patients (mean age 24 ± 1.9 years, 26 male) with a history of recurrent syncope and baseline positive head-up tilt table test (syncope or presyncope) were included. Oral amitriptyline treatment was given to all patients, with a starting dose of 10 mg once a day. Head-up tilt table test was performed in all patients 4 weeks after the treatment started. Patients were followed up clinically for 6 months.

Results: After 4 weeks, during head-up tilt table test in 69 patients (93%), syncope or presyncope was not seen and test was assumed as negative. At the end of the 6th month, 67 patients (91%) were free of symptoms. Only two patients (0.3%) did not tolerate amitriptyline due to side effects.

Conclusions: Oral amitriptyline can be used in the prevention of recurrent episodes of vasovagal syncope safely. However, randomized controlled studies are essential to assess the real effectiveness of this therapy.

A.N.E. 2007;12(2):153-157

Keywords: vasovagal syncope; amitriptyline; recurrent syncope; head-up tilt table test

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1542-474X.2007.00154.x

Affiliations: 1: Department of Cardiology, Hacettepe University Faculty of Medicine, Ankara, Turkey 2: Department of Cardiology, Gülhane Military Medical Academy, Ankara, Turkey

Publication date: 2007-04-01

Preliminary Observations on the Effect of Amitriptyline Treatment in Preventing Syncope Recurrence in Patients with Vasovagel Syncope

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