Clinical Health Updates

Midodrine prevents recurrent vasovagal syncope in kids

Clinical Question:
Does midodrine reduce the frequency of syncopal episodes in children with recurrent vasovagal syncope?

Bottom Line:
In this flawed study, midodrine (ProAmatine) was more effective than usual care in reducing the frequency of syncope in children with recurrent vasovagal syncope.

Qingyou Z, Junbao D, Chaoshu T. The efficacy of midodrine hydrochloride in the treatment of children with vasovagal syncope. J Pediatr 2006;149:777-780.

Study Design:
Randomized controlled trial (nonblinded)

In this Chinese study, the authors determine whether midodrine hydrochloride therapy can prevent vasovagal syncope (VVS) in pediatric patients. They included children with recurrent syncope (n = 26) randomly assigned into 2 groups. Group I comprised children given midodrine hydrochloride as first-line therapy in addition to conventional therapy, and group II comprised patients receiving conventional therapy only. Repeat head-up tilt (HUT) testing and follow-up of least 6 months were conducted to evaluate the therapeutic effectiveness and side effects of midodrine in treating VVS in children. The HUT-based effective rate was significantly higher in group I than in group II (75% vs 20%; P < .05). During the follow-up period, the recurrence of syncope was significantly lower in group I than in group II (P < .05).