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European Journal of Pediatrics

, Volume 156, Issue 10, pp 747–750 | Cite as

The role of serotonin re-uptake inhibitors in preventing recurrent unexplained childhood syncope – a preliminary report

  • M. Lenk
  • D. Alehan
  • Ş. Özme
  • A. Çeliker
  • S. Özer
CARDIOLOGY

Abstract

To assess the efficacy of a serotonin re-uptake inhibitor, sertraline hydrochloride, in preventing recurrent neurocardiogenic syncope, we studied 15 patients (10 female; mean age 12.9 ± 2 years) with positive head-upright tilt test and resistant to standard pharmacotherapy, atenolol or disopyramide. The patients were given 50 mg oral sertraline hydrochloride daily for 6 weeks. Intolerance to the drug was seen in 3 patients and 2 had syncopal episodes during the therapy. A head-upright tilt table test was then repeated in 10 patients. Six were tilt negative and asymptomatic over a mean follow up period of 7 ± 3 months while four remained tilt positive: two experienced marked hypotension and bradycardia, characterized as mixed type syncope, and two had cardiac asystole, lasting >10 s, during tilting, thereby exhibiting a cardio-inhibitory response.

Conclusion Sertraline hydrochloride may be useful in preventing recurrent neurocardiogenic syncope resistant to standard pharmacotherapy but careful clinical studies are essential before such a treatment strategy can be recommended since serious asystole could develop.

Key words Syncope Head-upright tilt Sertraline Children 

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Copyright information

© Springer-Verlag Berlin Heidelberg 1997

Authors and Affiliations

  • M. Lenk
    • 1
  • D. Alehan
    • 1
  • Ş. Özme
    • 1
  • A. Çeliker
    • 1
  • S. Özer
    • 1
  1. 1.Paediatric Cardiology Unit, Department of Paediatrics, Hacettepe University, Faculty of Medicine, Ankara, TurkeyTR

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