ReviewJournal of neural transmission (Vienna, Austria : 1996)2017
Evidence-based treatment of neurogenic orthostatic hypotension and related symptoms.
Review in Journal of neural transmission (Vienna, Austria : 1996), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT06072105 (Medical Decision Making in Multiple System Atrophy), which is not on this map. Cited by 50 papers, 2 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.
Medical Decision Making in Multiple System Atrophy: Developing Personalized Best Medical Care with Integrated Telemedicine and Mobile Palliative Care for Individuals with Multiple System Atrophy
Who cites it
50 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Diagnosis and treatment of autonomic failure, pain and sleep disturbances in Parkinson's disease: guideline "Parkinson's disease" of the German Society of Neurology.Journal of neurology · 2025Guideline
- Hemodynamic Effects of the Osmopressor Response: A Systematic Review and Meta-Analysis.Journal of the American Heart Association · 2023Pooled it
- Acute effects of bolus water intake on post-exercise orthostatic hypotension and cardiovascular hemodynamics.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2025Trial
- Clinical Correlates of Efficacy of Pyridostigmine in the Treatment of Orthostatic Hypotension.Hypertension (Dallas, Tex. : 1979) · 2025Trial
- Impact of COVID‑19 infection on subsequent prescriptions of autonomic dysfunction pharmacotherapy: a nationwide propensity‑score‑matched Cohort study in Japan.Annals of medicine · 2026Article
- Article
- Autonomic dysfunction in patients with wild-type transthyretin amyloidosis.Journal of neurology · 2026Article
- How to treat cardiovascular autonomic failure in Parkinson's disease.Journal of neural transmission (Vienna, Austria : 1996) · 2026Review
- Review
- Orthostatic hypotension in Parkinson's disease: therapeutic considerations.Therapeutic advances in neurological disorders · 2025Review
- Article
- The Clinical Management of Electrical Stimulation Therapies in the Rehabilitation of Individuals with Spinal Cord Injuries.Journal of clinical medicine · 2024Review
- Correlations between serotonin impairments and clinical indices in multiple system atrophy.European journal of neurology · 2024Article
- Epidemiology and Risk Factors for Orthostatic Hypotension and Its Severity in Residents Aged > 60 years: A Cross-Sectional Study.International journal of hypertension · 2024Article
- Non-Pharmacological Treatment of Autonomic Dysfunction in Parkinson's Disease and Other Synucleinopathies.Journal of Parkinson's disease · 2024Review
- Pain in Multiple System Atrophy a Systematic Review and Meta-Analysis.Movement disorders clinical practice · 2023Review
- [S1 guidelines for the management of postviral conditions using the example of post-COVID-19].Wiener klinische Wochenschrift · 2023Article
- Multiple system atrophy.Practical neurology · 2023Review
- Ataxias: Hereditary, Acquired, and Reversible Etiologies.Seminars in neurology · 2023Article
- Neurodegenerative diseases and blood pressure variability: A comprehensive review from HOPE Asia.Journal of clinical hypertension (Greenwich, Conn.) · 2022Review
Corrections and comments
- Erratum issued
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Neurogenic orthostatic hypotension, postprandial hypotension and exercise-induced hypotension are common features of cardiovascular autonomic failure. Despite the serious impact on patient's quality of life, evidence-based guidelines for non-pharmacological and pharmacological management are lacking at present. Here, we provide a systematic review of the literature on therapeutic options for neurogenic orthostatic hypotension and related symptoms with evidence-based recommendations according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE). Patient's education and non-pharmacological measures remain essential, with strong recommendation for use of abdominal binders. Based on quality of evidence and safety issues, midodrine and droxidopa reach a strong recommendation level for pharmacological treatment of neurogenic orthostatic hypotension. In selected cases, a range of alternative agents can be considered (fludrocortisone, pyridostigmine, yohimbine, atomoxetine, fluoxetine, ergot alkaloids, ephedrine, phenylpropanolamine, octreotide, indomethacin, ibuprofen, caffeine, methylphenidate and desmopressin), though recommendation strength is weak and quality of evidence is low (atomoxetine, octreotide) or very low (fludrocortisone, pyridostigmine, yohimbine, fluoxetine, ergot alkaloids, ephedrine, phenylpropanolamine, indomethacin, ibuprofen, caffeine, methylphenidate and desmopressin). In case of severe postprandial hypotension, acarbose and octreotide are recommended (strong recommendation, moderate level of evidence). Alternatively, voglibose or caffeine, for which a weak recommendation is available, may be useful.
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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.