Trial reportAnnals of clinical and translational neurology2020
Efficacy of atomoxetine versus midodrine for neurogenic orthostatic hypotension.
Trial report in Annals of clinical and translational neurology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 17 papers.
What it found
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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
17 citing papers in PubMed, 29 citations in OpenAlex.
- Safety and efficacy of ampreloxetine in symptomatic neurogenic orthostatic hypotension: a phase 2 trial.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2021Trial
- How to treat cardiovascular autonomic failure in Parkinson's disease.Journal of neural transmission (Vienna, Austria : 1996) · 2026Review
- Approach to Cardiovascular Autonomic Dysfunction in Patients with Synucleinopathies.Movement disorders clinical practice · 2025Review
- Review
- Review
- Update on the Treatment of Autonomic Disorders.Current treatment options in neurology · 2025Article
- Oral blood pressure augmenting agents for intravenous vasopressor weaning.World journal of clinical cases · 2024Review
- Norepinephrine Reuptake Inhibition, an Emergent Treatment for Neurogenic Orthostatic Hypotension.Hypertension (Dallas, Tex. : 1979) · 2024Review
- Atomoxetine for Intradialytic Hypotension in a Patient on Hemodialysis: A Case Report.Kidney medicine · 2024Article
- Symptomatic Care in Multiple System Atrophy: State of the Art.Cerebellum (London, England) · 2023Review
- New horizons in the ageing autonomic nervous system: orthostatic hypotension and supine hypertension.Age and ageing · 2022Article
- Orthostatic Hypotension: Management of a Complex, But Common, Medical Problem.Circulation. Arrhythmia and electrophysiology · 2022Review
- The Pathogenesis and Treatment of Cardiovascular Autonomic Dysfunction in Parkinson's Disease: What We Know and Where to Go.Aging and disease · 2021Review
- Orthostatic hypotension in older people: considerations, diagnosis and management.Clinical medicine (London, England) · 2021Review
- Pharmacologic treatment of orthostatic hypotension.Autonomic neuroscience : basic & clinical · 2020Review
- Current Management and Emerging Therapies in Multiple System Atrophy.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2020Review
- Efficacy of atomoxetine versus midodrine for neurogenic orthostatic hypotension.Annals of clinical and translational neurology · 2020Article
Corrections and comments
- Erratum issued
Authors and funding
14 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThe efficacy and safety of 1-month atomoxetine and midodrine therapies were compared. Three-month atomoxetine and combination therapies were investigated for additional benefits.
methodsThis prospective open-label randomized trial included 50 patients with symptomatic neurogenic orthostatic hypotension (nOH). The patients received either atomoxetine 18 mg daily or midodrine 5 mg twice daily and were evaluated 1 and 3 months later. Those who still met the criteria for nOH at 1 month received both midodrine and atomoxetine for an additional 2 months, and if not, they continued their initial medication. The primary outcome was an improvement in orthostatic blood pressure (BP) drop (maximum BP change from supine to 3 min after standing) at 1 month. The secondary endpoints were symptom scores, percentage of patients with nOH at 1 and 3 months.
resultsPatients with midodrine or atomoxetine treatment showed comparative improvement in the orthostatic BP drop, and overall only 26.2% of the patients had nOH at 1 month, which was similar between the treatment groups. Only atomoxetine resulted in significant symptomatic improvements at 1 month. For those without nOH at 1 month, there was additional symptomatic improvement at 3 months with their initial medication. For those with nOH at 1 month, the combination treatment resulted in no additional improvement. Mild-to-moderate adverse events were reported by 11.6% of the patients.
interpretationOne-month atomoxetine treatment was effective and safe in nOH patients. Atomoxetine improved orthostatic BP changes as much as midodrine and was better in terms of ameliorating nOH symptoms.
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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.