About 20% of adults faint recurrently. These patients are often highly symptomatic, have
problems with employment and driving and have reduced quality of life. There are no therapies
that have withstood the test of adequately designed and conducted randomized clinical trials.
Midodrine is a prodrug whose metabolite is an alpha-1 adrenergic agonist that increases
venous return to the heart and raises blood pressure. There is considerable lower level
evidence that it might prevent vasovagal syncope.
The investigators will test the hypothesis that Midodrine prevents recurrences of syncope in
patients with moderate to severe vasovagal syncope.