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.

Reference:
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)

Synopsis:
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).