Abstract 470: Treatment of Orthostatic Hypotension with the Combination Ergotamine and Caffeine
Orthostatic hypotension is the most disabling symptom of autonomic failure. Severely affected patients often require medication to counteract the blood pressure fall and to improve pre-syncopal symptoms on standing. Isolated clinical observations have suggested that the combination ergotamine and caffeine can be useful in the treatment of orthostatic hypotension. The aim of this study was to examine the effect of the combination ergotamine and caffeine on blood pressure and pre-syncopal symptoms on standing in a group of patients with autonomic failure. A total of 12 patients participated in this study. Eight were men and the average age was 64±10 years. The combination ergotamine and caffeine increased seated SBP by 19 mm Hg compared with placebo (95% CI: -2 to 40 mm Hg, P=0.07) (Figure A) and reduced the orthostatic symptom score by 9 points (95% CI: 0.9 to 16, P=0.03), compared with baseline (Figure B). In conclusion, the combination ergotamine and caffeine could be an alternative therapy for orthostatic hypotension in patients with autonomic failure.
- © 2012 by American Heart Association, Inc.