fludrocortisone for vasovagal syncope
vasovagal syncope is pretty common, but there are no documented effective treatments. Fludrocortisone has potential by improving venous return: its efficacy was evaluated in the Prevention of Syncope Trial 2 -- POST 2 trial (see syncope fludrocortisone jacc2016 in dropbox , or Sheldon R. JACC 2016; 68: 1). details: --210 patients (71% female, median age 30, BMI 24, HR 70 bpm, BP 112/70) with a mean of 15 syncopal episodes over 9 years --randomized to fludrocortisone at the highest tolerated doses (from 0.05-0.2 mg/d, titrated over 2 weeks, with most achieving the 0.2 mg dose) vs placebo and followed for 1 year --inclusion criteria: >13 yo , >2 lifetime syncopal episodes; exclusions: diabetes, hepatic disease BP>135/85, "significant comorbidities", or if when standing 5 minutes they had postural tachycardia of >30 bpm, or orthostatic hypotension of >20/10 mmHg. --results --9...