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>Journals >Gaceta Médica de México >Year 2008, Issue 6

Márquez MF, Urias-Medina K, Gómez-Flores J, Sobrino A, Sotomayor-González A, González-Hermosillo A, Cárdenas M
Comparación de metoprolol versus clonazepam como tratamiento de primera intención en pacientes con síncope neurocardiogénico
Gac Med Mex 2008; 144 (6)

Language: Español
References: 12
Page: 503-508
PDF: 47.06 Kb.

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Objective: We compared the effects of a metoprolol and clonazepam in patients with neurocardiogenic syncope. Methods: We compared the effects of a metoprolol and clonazepam in a prospective, randomised trial in 54 patients. Patients were randomly assigned to metoprolol (starting dose 50 mg bid) or clonazepam (starting dose 0.5 mg qd). We assessed a primary combined endpoint of syncope and pre-syncope on a follow-up of 12 months. Results: The primary combined endpoint of syncope and presyncope occurred in the metoprolol group in 3, 4, and 10% of patients at 3, 6, and 12 months respectively. In the clonazepam group it was no recurrence in the first 6 months, and 5% recurrence at 12 months follow-up (non significant differences between groups). Clinical symptoms commonly associated with neurally mediated syncope were decreased similarly in both treatment groups, in the metoprolol group from 5.2±2.5 to 1.9±2.1 (p ‹ 0.001) and in the clonazepam group from 5.5±2.5 to 1.5±2.2 (p‹0.001). Conclusions: Pharmacological treatment of neurocardiogenic syncope with metoprolol or clonazepam resulted in similar prevention of syncope and presyncope. Both treatments decreased clinical symptoms but complete symptomatic resolution was rarely observed.

Key words: Neurocardiogenic syncope, metoprolol, clonazepam, head tilt-test.


  1. Hermosillo AG, Márquez MF, Jáuregui-Renaud K, Cárdenas M. Orthostatic hypotension, 2001. Cardiol Rev 2001;9:339-347.

  2. Kadri NN, Hee TT, Rovang KS, Mohiuddin SM, Ryan T, Ashraf R, et al. Efficacy and safety of clonazepam in refractory neurally mediated syncope. Pacing Clin Electrophysiol 1999;22:307-314.

  3. Sutton R, Petersen M, Brignole M. Proposed classification for tilt induced vasovagal syncope. Eur J Cardiac Pacing Electrophysiol 1992;2:180-183.

  4. Dawson-Saunders B, Trapp RG. Bioestadística médica. México: El Manual Moderno; 1997. pp. 223-248.

  5. Grubb BP, Wolfe DA, Samoil D, Temesy-Armos P, Han H, Elliot L. Usefulness of fluoxetine hydrochloride for prevention of resistant upright tilt induced syncope. PACE 1993;16:458-456.

  6. Ward CR, Gray JC, Gilroy JJ, Kenny RA. Midodrine: A role in the management of neurocaardiogenic syncope. Heart 1998;79:45-49.

  7. Girolamo ED, Di Lorio C, Sabatini P, Leonzio L, Barbone C, Barsotti A. Effects of paroxetine hydrochloride, a selective serotonin reuptake inhibitor on refractory vasovagal syncope: a randomized, double-blind, placebo-controlled study. J Am Coll Cardiol 1999;33:1227-1230.

  8. Jáuregui-Renaud K, Márquez MF, Hermosillo AG, Sobrino A, Lara JL, Kostine A, et al. Paced breathing can prevent vasovagal syncope during head-up tilt testing. Can J Cardiol 2003;19:698-700.

  9. Gielerak G, Makowski K, Cholewa M. Prognostic value of head-up tilt test with intravenous beta-blocker administration in assessing the efficacy of therapy in patients with vasovagal syncope. Ann Noninvasive Electrocardiol 2005;10:65-72.

  10. Ventura R, Maas R, Zeidler D, Schoder V, Nienaber CA, Schuchert A, et al. A randomized and controlled pilot trial of beta-blockers for the treatment of recurrent syncope in patients with a positive or negative response to head-up tilt test. Pacing Clin Electrophysiol 2002;25:816-821.

  11. Brignole M. Randomized clinical trials of neurally mediated syncope. J Cardiovasc Electrophysiol 2003;14:S64-S69.

  12. Madrid AH, Ortega J, Rebollo J, Manzano JG, Segovia JG, Sánchez A, et al. Lack of efficacy of atenolol for the prevention of neurally mediated syncope in a highly symptomatic population: A prospective, double-blind, randomized and placebo-controlled study. J Am Coll Cardiol 2001;37:554-559.

>Journals >Gaceta Médica de México >Year 2008, Issue 6

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