Treatment of Orthostatic Hypotension
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Purpose
The purpose of this study is to try different medications in patients with low blood pressure and other problems with their involuntary (autonomic) nervous system. The pharmacological trials in this study will perhaps lead to more effective treatment. This study consists of single dose trials, dose selection trials, 5-day trials and chronic (approximately 2 months) trials.
| Condition | Intervention | Phase |
|---|---|---|
|
Autonomic Nervous System Diseases Orthostatic Hypotension Dopamine Beta-Hydroxylase Deficiency Orthostatic Intolerance |
Drug: droxidopa Drug: placebo Drug: alpha-methyldopa Drug: carbidopa Drug: metyrosine Drug: levodopa Drug: atomoxetine Drug: metoclopramide |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Non-Randomized Endpoint Classification: Efficacy Study Intervention Model: Crossover Assignment Masking: Single Blind (Subject) Primary Purpose: Treatment |
| Official Title: | Treatment of Hypotensive Patients Having a Unique Pattern of Autonomic Symptoms |
- Change in blood pressure with standing [ Time Frame: following 5 days of medication ] [ Designated as safety issue: No ]
- length of time subject is able to stand [ Time Frame: following 5 days of medication ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 25 |
| Study Start Date: | January 2004 |
| Estimated Study Completion Date: | December 2015 |
| Estimated Primary Completion Date: | December 2015 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Placebo Comparator: 2 |
Drug: placebo
same frequency as experimental medication
|
| Experimental: 1 |
Drug: droxidopa
up to 300mg four times daily
Drug: alpha-methyldopa
up to 250mg two times daily
Other Name: Aldomet
Drug: carbidopa
up to 25mg four times daily
Other Name: Lodosyn
Drug: metyrosine
up to 1000mg three times daily
Other Name: Demser
Drug: levodopa
up to 250mg three times daily
Other Name: Larodopa
Drug: atomoxetine
up to 40mg twice daily
Other Name: Strattera
Drug: metoclopramide
up to 10mg four times daily
Other Name: Reglan
|
Detailed Description:
We see many patients at the Autonomic Dysfunction Center who can be given a fairly definitive diagnosis, e.g., Orthostatic Intolerance, Pure Autonomic Failure, Multiple System Atrophy, and Baroreflex Failure. However, some patients present with a unique constellation of symptoms of autonomic dysfunction so that they do not fit into a diagnostic category. We hypothesize that a genetic cause exists in some of these patients. We further propose that our comprehensive evaluation of these patients will provide us with information on the pathophysiology of their condition and assist us in optimizing their treatment.
Eligibility| Ages Eligible for Study: | 18 Years to 70 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- patients with severe orthostatic hypotension and other autonomic symptoms who do not meet criteria for one of our standard diagnoses
- non-smokers
- drug-free
- able to give informed consent
- free of pulmonary, renal, hematopoietic, hepatic and cardiac disease
Exclusion Criteria:
- medications affecting the autonomic nervous system
- any chronic illness (cardiac, pulmonary, endocrine, gastrointestinal, rheumatologic)
- anemia (Hct < 30)
- women of childbearing age who are pregnant or nursing
- smokers
Contacts and Locations| Contact: Bonnie K Black, RN | adc.research@vanderbilt.edu | |
| Contact: Emily M Garland, PhD | adc.research@vanderbilt.edu |
| United States, Tennessee | |
| Vanderbilt University | Recruiting |
| Nashville, Tennessee, United States, 37232 | |
| Principal Investigator: David Robertson, MD | |
| Sub-Investigator: Emily M Garland, PhD | |
| Sub-Investigator: Italo Biaggioni, MD | |
| Sub-Investigator: Satish R Raj, MD | |
| Principal Investigator: | David Robertson, MD | Vanderbilt University |
More Information
Additional Information:
No publications provided
| Responsible Party: | Emily M. Garland, Research Associate Professor, Vanderbilt University |
| ClinicalTrials.gov Identifier: | NCT00581477 History of Changes |
| Other Study ID Numbers: | 030750, HL056693 |
| Study First Received: | December 22, 2007 |
| Last Updated: | April 9, 2013 |
| Health Authority: | United States: Food and Drug Administration United States: Institutional Review Board |
Keywords provided by Vanderbilt University:
|
autonomic nervous system diseases blood pressure congenital orthostasis catecholamines |
Additional relevant MeSH terms:
|
Autonomic Nervous System Diseases Primary Dysautonomias Hypotension Hypotension, Orthostatic Orthostatic Intolerance Mitral Valve Prolapse Neurocirculatory Asthenia Nervous System Diseases Vascular Diseases Cardiovascular Diseases Neurologic Manifestations Signs and Symptoms Heart Valve Prolapse Heart Valve Diseases Heart Diseases |
Anxiety Disorders Mental Disorders Droxidopa Carbidopa Levodopa Metoclopramide Alpha-Methyltyrosine Methyldopa Atomoxetine Antiparkinson Agents Anti-Dyskinesia Agents Central Nervous System Agents Therapeutic Uses Pharmacologic Actions Enzyme Inhibitors |
ClinicalTrials.gov processed this record on May 21, 2013