Grubb B P, Samoil D, Kosinski D, Wolfe D, Lorton M, Madu E
Department of Medicine, Medical College of Ohio, Toledo 43699.
Am J Med. 1994 Oct;97(4):366-8. doi: 10.1016/0002-9343(94)90304-2.
To evaluate the usefulness of fluoxetine hydrochloride in the treatment of patients with severe refractory orthostatic hypotension.
Prospective, nonrandomized study.
Five patients (3 men, 2 women with a mean age of 67 +/- 7 years with chronic symptomatic orthostatic hypotension resistant to or intolerant of other therapies.
Symptoms and orthostatic responses were recorded in the baseline state. Fluoxetine hydrochloride 20 mg orally once daily was started and patients were reevaluated after 6 to 8 weeks of therapy.
All patients demonstrated orthostatic hypotension (20 mm Hg or greater decline in systolic blood pressure) associated with symptoms (eg, dizziness, vertigo, near syncope) in the baseline state. After 6 to 8 weeks of fluoxetine therapy, 2 patients reported resolution of all symptoms, 2 had a marked reduction in symptoms, and 1 patient experienced no effect. Orthostatic responses were attenuated in 4 of the 5 patients (80%).
Fluoxetine hydrochloride may be an effective therapy for some patients with recurrent severe orthostatic hypotension refractory to other forms of therapy.
评估盐酸氟西汀治疗重度难治性直立性低血压患者的有效性。
前瞻性、非随机研究。
5例患者（3例男性，2例女性），平均年龄67±7岁，患有慢性症状性直立性低血压，对其他治疗耐药或不耐受。
记录基线状态下的症状和直立反应。开始口服盐酸氟西汀20mg，每日1次，治疗6至8周后对患者进行重新评估。
所有患者在基线状态下均表现出直立性低血压（收缩压下降20mmHg或更多）并伴有症状（如头晕、眩晕、接近晕厥）。氟西汀治疗6至8周后，2例患者报告所有症状消失，2例症状明显减轻，1例患者无效。5例患者中有4例（80%）的直立反应减弱。
盐酸氟西汀可能是治疗某些对其他形式治疗无效的复发性重度直立性低血压患者的有效疗法。
