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new drug for sudden dizziness/Mayo Clinic

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This is a really good article. I hope it might prove helpful to someone. I am

sharing it with my fellow EDSer's, physicians, etc. because there are seem to be

so many EDSer's these days who are being diagnosed with some form of

Dysautonomia.

~LoneStarRose~

(~~)

Mayo Clinic Researchers Devise New Treatment for People Who

Experience Dizziness Upon Suddenly Rising From a Prone Position

VIDEO ALERT: Video sound bites and b-roll will be fed on Thursday,

Sept. 25, 2003. See the end of this release for details. Video feed

contains 1) an interview with Dr. Low explaining the

disorder, 2) a demonstration of his test for the disorder on a

volunteer in his Mayo Clinic lab and

ROCHESTER, Minn. -- Mayo Clinic researchers have developed a drug

treatment to stop the dizziness, light-headedness and fainting that

patients experience who suffer from a common form of impaired nerve

transmission known as " autonomic failure. "

The failure of autonomic nerve function leads to the sudden drop in

blood pressure that causes dizziness, and is a frequent side effect

of diabetes and Parkinson's Disease, among others. It occurs when a

patient suddenly changes body position, from lying down to standing

up. The medical term for this sudden dip in blood pressure

is " orthostatic hypotension. " Results from the Mayo Clinic study of

15 patients treated with the drug pyridostigmine are so encouraging

that medical journal editorial writer Schondorf, M.D., Ph.D.,

describes it as " a potentially ideal therapeutic agent. " Commenting

on the Mayo Clinic research report that appears in this month's

Journal of Neurology and Neurosurgical Psychiatry,

http://jnnp.bmjjournals.com, Dr. Schondorf says in the accompanying

editorial that " it is evident that a drug that would function without

troubling side effects would be very desirable. "

No drug treatments that are free of side effects are currently

available to treat orthostatic hypotension. The most dangerous side

effect of available treatments is increased stress on the heart from

high blood pressure when the patient is lying down.

Low, M.D., Mayo Clinic neurologist and senior author of this

study, describes the significance of the work this way: " What this

drug does is reduce the fall in blood pressure when patients stand

up. That's good. That's what we want because it stops the dizziness.

At the same time, the drug has no effect on the lying-down blood

pressure -- that's also good, because that doesn't stress the heart

and brain. So we have the best of both worlds; no dizziness and no

stress on the heart and brain. It really works like a magic bullet

that way. " Mayo Clinic's Research

In their study, Dr. Low and colleagues focused on the body's system

that detects a fall in blood pressure called baroreflex. It's a two-

part system that sends a message to the brain. The first part of

baroreflex tells the heart to speed up. The second part of the

baroreflex sends messages down the spinal cord into the blood

vessels, signaling them to constrict to bring blood pressure back up.

Dr. Low and colleagues concentrated on autonomic signaling.

In their study they report that the signaling system is a two-neuron

system that meets at a body part that is like a relay station for

nerve messages. It's called the autonomic ganglia.

The presence of the drug pyridostigmine improves nerve communication

at this site at the time when patients with impaired baroreflex most

need it: when they stand up.

The drug pyridostigmine works by blocking a compound that otherwise

would break down a key nerve-communicating chemical. This block

allows the key nerve-communicating chemical to do its job so the

blood vessels get the message to stop blood pressure from falling.

Explains Dr. Low: " When you are lying down, nerve traffic through

that ganglia is very minimal. When you stand up, nerve traffic picks

up. But as a result of the blocking done by pyridostigmine, nerve

traffic through the ganglia is enhanced so the ganglia can

communicate more effectively the message to blood vessels to

constrict. "

Researchers also found another positive effect of the drug: It

relieves a second common condition patients with autonomic failure

experience, constipation. The drug helps by increasing activity in

the colon.

This research was performed at Mayo Clinic's General Clinical

Research Center. Background: The Problem

The change of the body from the lying-down, horizontal position to

the standing-up, vertical position is performed effortlessly by most

people. When there is no autonomic nerve damage, the body flawlessly

and automatically accommodates this by moving most of the three cups

of blood that need to be transferred from the chest to the blood

vessels of the lower trunk within 10 seconds. It does this by

speeding up the heart rate and adjusting vessel tension. The

remainder of the blood is transferred within three to five minutes.

But in patients who have suffered damage to the baroreflex that

maintains normal blood pressure, these compensatory pumping and

vessel-stress adjustments are not made.

The Mayo Clinic pioneered the diagnosis and advanced treatment of

autonomic nerve function disorder in 1983 when Dr. Low designed the

first laboratory and a comprehensive series of tests for evaluating

patients with this disorder. He is director of the Mayo Autonomic

Disorders Project. As the first program grant for autonomic disorders

to be funded by the National Institutes of Health, it is currently

running three NIH studies.

Dr. Low says that as encouraging as these early results with the drug

pyridostigmine are, results from the NIH-funded trials now underway

at the Mayo Clinic are needed to confirm these early findings. If

they do, the drug will likely then be a candidate for general

prescriptive use.

Video and Audio Clips

NOTE: To arrange an interview with a patient in Calgary, Alberta,

Canada, please contact Copeland in Mayo Clinic Communications,

.

Copeland

(days)

(evenings)

e-mail: newsbureau@...

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