Trial reportClinical science (London, England : 1979)2014
A double-blind placebo-controlled cross-over study of the vascular effects of midodrine in neuropathic compared with hyperadrenergic postural tachycardia syndrome.
Trial report in Clinical science (London, England : 1979), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04345432 (Gabapentin Treatment of Postural Tachycardia Syndrome), which is not on this map. Cited by 33 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Gabapentin Treatment of Postural Tachycardia Syndrome (PoTS): a Pilot Study
Who cites it
33 citing papers in PubMed, 3 syntheses or guidelines pooled it, 72 citations in OpenAlex.
- Systematic literature review: treatment of postural orthostatic tachycardia syndrome (POTS).Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2026Pooled it
- Oral medications for the treatment of postural orthostatic tachycardia syndrome; a systematic review of studies before and during the COVID-19 pandemic.Frontiers in neurology · 2024Pooled it
- Efficacy of β-Blockers on Postural Tachycardia Syndrome in Children and Adolescents: A Systematic Review and Meta-Analysis.Frontiers in pediatrics · 2019Pooled it
- Efficacy of Propranolol, Bisoprolol, and Pyridostigmine for Postural Tachycardia Syndrome: a Randomized Clinical Trial.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2018Trial
- Understanding the placebo effect in clinical trials for postural tachycardia syndrome.Clinical and experimental pharmacology & physiology · 2014Trial
- Midodrine exposure trends and outcomes reported to United States poison centers: 2000-2023.Clinical toxicology (Philadelphia, Pa.) · 2025Article
- Vascular Pathogenesis in Acute and Long COVID: Current Insights and Therapeutic Outlook.Seminars in thrombosis and hemostasis · 2025Review
- Blood Pressure Regulation in Post-COVID POTS: Beyond Sinus Tachycardia.Hypertension (Dallas, Tex. : 1979) · 2024Article
- Hyperadrenergic Postural Tachycardia Syndrome: Clinical Biomarkers and Response to Guanfacine.Hypertension (Dallas, Tex. : 1979) · 2024Article
- Management of Postural Orthostatic Tachycardia Syndrome in Pediatric Patients: A Clinical Review.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2024Article
- Navigating Complexity in Postural Orthostatic Tachycardia Syndrome.Biomedicines · 2024Review
- Long COVID and hypermobility spectrum disorders have shared pathophysiology.Frontiers in neurology · 2024Article
- Article
- Predicting Therapeutic Efficacy of Pharmacological Treatments in Children with Postural Orthostatic Tachycardia Syndrome: A Mini-Review.Children (Basel, Switzerland) · 2023Review
- Article
- Choices and Challenges With Drug Therapy in Postural Orthostatic Tachycardia Syndrome: A Systematic Review.Cureus · 2023Review
- Review
- Postural Orthostatic Tachycardia Syndrome in COVID-19: A Contemporary Review of Mechanisms, Clinical Course and Management.Vascular health and risk management · 2023Review
- Management of Postural Orthostatic Tachycardia Syndrome in the Absence of Randomized Controlled Trials.The Journal of innovations in cardiac rhythm management · 2021Article
- Circulating levels of growth hormone in postural orthostatic tachycardia syndrome.Scientific reports · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
POTS (postural tachycardia syndrome) is a chronic form of OI (orthostatic intolerance). Neuropathic POTS is characterized by decreased adrenergic vasoconstriction, whereas hyperadrenergic POTS exhibits increased adrenergic vasoconstriction. We hypothesized that midodrine, an α1-adrenergic receptor agonist, would increase CVR (calf vascular resistance), decrease C(v) (calf venous capacitance) and decrease orthostatic tachycardia in neuropathic POTS, but not alter haemodynamics in hyperadrenergic POTS. A total of 20 POTS patients (12 neuropathic and eight hyperadrenergic), ages 12-20 years, participated in this randomized placebo-controlled double-blind cross-over study. Of these subjects, 15 were female. POTS subjects received 2 weeks of treatment with midodrine or placebo, with increased dosing from 2.5 to 10 mg three times daily. Following a 7-day drug-washout period, subjects received the cross-over treatment. HR (heart rate), MAP (mean arterial pressure), Q(calf) (calf blood flow) and CVR were measured supine and during 35° HUT (head-up tilt). C(v) was measured supine. In neuropathic POTS, midodrine decreased supine HR, Q(calf) and C(v), while increasing MAP and CVR compared with placebo. During HUT, in neuropathic POTS, midodrine decreased HR, Q(calf) and C(v), while increasing MAP and CVR. In hyperadrenergic POTS, placebo and midodrine both decreased upright HR and increased supine CVR. Placebo also increased supine C(v), compared with midodrine in hyperadrenergic POTS. Therefore midodrine improved postural tachycardia in neuropathic POTS by increasing CVR and decreasing Q(calf) and C(v), whereas these effects were not seen in hyperadrenergic POTS patients who experienced a placebo effect. This suggests that midodrine is probably an effective treatment for neuropathic POTS, but not for hyperadrenergic POTS.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.