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Nonpharmacological treatment, fludrocortisone, and domperidone for orthostatic hypotension in Parkinson's disease
Author(s) -
Schoffer Kerrie L.,
Henderson Robert D.,
O'Maley Karen,
O'Sullivan John D.
Publication year - 2007
Publication title -
movement disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.352
H-Index - 198
eISSN - 1531-8257
pISSN - 0885-3185
DOI - 10.1002/mds.21428
Subject(s) - orthostatic vital signs , domperidone , midodrine , fludrocortisone , medicine , parkinson's disease , physical therapy , randomized controlled trial , clinical global impression , blood pressure , anesthesia , physical medicine and rehabilitation , surgery , disease , dopamine , hydrocortisone , alternative medicine , pathology , placebo
There is limited evidence for the treatment of orthostatic hypotension in idiopathic Parkinson's disease. The objective of this study was to determine the efficacy of three treatments (nonpharmacological therapy, fludrocortisone, and domperidone). Phase I assessed the compliance, safety, and efficacy of nonpharmacological measures. Phase II was a double‐blind randomized controlled crossover trial of the two medications. Primary outcome measures consisted of the orthostatic domain of the Composite Autonomic Symptom Scale (COMPASS‐OD), a clinical global impression of change (CGI), and postural blood pressure testing via bedside sphygmomanometry (Phase I) or tilt table testing (Phase II). For the 17 patients studied, nonpharmacological therapy did not significantly alter any outcome measure. Both medications improved the CGI and COMPASS‐OD scores. There was a trend towards reduced blood pressure drop on tilt table testing, with domperidone having a greater effect. © 2007 Movement Disorder Society