Trial reportJournal of the American Heart Association2013
Effects of norepinephrine reuptake inhibition on postural tachycardia syndrome.
Trial report in Journal of the American Heart Association, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
24 citing papers in PubMed, 3 syntheses or guidelines pooled it, 62 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
- Faintly tired: a systematic review of fatigue in patients with orthostatic syncope.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2022Pooled it
- Pharmacological norepinephrine transporter inhibition for the prevention of vasovagal syncope in young and adult subjects: A systematic review and meta-analysis.Heart rhythm · 2020Pooled it
- Effect of High Dietary Sodium Intake in Patients With Postural Tachycardia Syndrome.Journal of the American College of Cardiology · 2021Trial
- Understanding the placebo effect in clinical trials for postural tachycardia syndrome.Clinical and experimental pharmacology & physiology · 2014Trial
- Underuse of Pharmacologic Therapies for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Before Specialist Evaluation.Annals of family medicine · 2026Article
- Short-term heart rate variability is preserved in Parkinson's disease under atomoxetine.Brain communications · 2026Article
- The Relation Between Cardiac Output and Cerebral Blood Flow in ME/CFS Patients with a POTS Response During a Tilt Test.Journal of clinical medicine · 2025Article
- Palmitoylation regulates norepinephrine transporter uptake, surface localization, and total expression with pathogenic implications in postural orthostatic tachycardia syndrome.Journal of neurochemistry · 2025Article
- Update on the Treatment of Autonomic Disorders.Current treatment options in neurology · 2025Article
- 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
- Cardiovascular autonomic dysfunction in post-COVID-19 syndrome: a major health-care burden.Nature reviews. Cardiology · 2024Review
- Narrative Review of Postural Orthostatic Tachycardia Syndrome: Associated Conditions and Management Strategies.US cardiology · 2023Review
- Diagnosis and management of postural orthostatic tachycardia syndrome.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2022Review
- Postural orthostatic tachycardia syndrome (POTS): State of the science and clinical care from a 2019 National Institutes of Health Expert Consensus Meeting - Part 1.Autonomic neuroscience : basic & clinical · 2021Article
- The Relationship Between Hypermobile Ehlers-Danlos Syndrome (hEDS), Postural Orthostatic Tachycardia Syndrome (POTS), and Mast Cell Activation Syndrome (MCAS).Clinical reviews in allergy & immunology · 2020Review
- New Insights into the Mechanism of Action of Viloxazine: Serotonin and Norepinephrine Modulating Properties.Journal of experimental pharmacology · 2020Article
- Postural tachycardia syndrome - Diagnosis, physiology, and prognosis.Autonomic neuroscience : basic & clinical · 2018Review
- Polymorphism of SLC6A2 gene does not influence outcome of myocardialJournal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2018Article
- Atomoxetine-induced hyperadrenergic postural tachycardia syndrome: a case report.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2018Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 1 institution in 1 country.
Funding
Abstract
backgroundPostural tachycardia syndrome (POTS) is a disorder of chronic orthostatic intolerance accompanied by excessive orthostatic tachycardia. Patients with POTS commonly have comorbid conditions such as attention deficit hyperactivity disorder, depression, or fibromyalgia that are treated with medications that inhibit the norepinephrine reuptake transporter (NRI). NRI medications can increase sympathetic nervous system tone, which may increase heart rate (HR) and worsen symptoms in POTS patients. We sought to determine whether NRI with atomoxetine increases standing tachycardia or worsens the symptom burden in POTS patients. METHODS AND
resultsPatients with POTS (n = 27) underwent an acute drug trial of atomoxetine 40 mg and placebo on separate mornings in a randomized, crossover design. Blood pressure (BP), HR, and symptoms were assessed while seated and after standing prior to and hourly for 4 hours following study drug administration. Atomoxetine significantly increased standing HR compared with placebo (121 ± 17 beats per minute versus 105 ± 15 beats per minute; P = 0.001) in POTS patients, with a trend toward higher standing systolic BP (P = 0.072). Symptom scores worsened with atomoxetine compared to placebo (+4.2 au versus -3.5 au; P = 0.028) from baseline to 2 hours after study drug administration.
conclusionNorepinephrine reuptake inhibition with atomoxetine acutely increased standing HR and symptom burden in patients with POTS.
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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.