Metoprolol for Fainting

This trial tests whether metoprolol, a common heart medication, can reduce fainting episodes in individuals who frequently experience vasovagal syncope (a type of fainting caused by a sudden drop in heart rate and blood pressure). The researchers aim to determine if metoprolol prevents these fainting spells more effectively than a placebo (a pill with no active medicine) in affected individuals. This study may suit people aged 40 and older who have experienced at least one fainting spell in the past year and have been diagnosed with vasovagal syncope. Those who often faint and find it disrupts daily life might find this trial a good fit. As a Phase 4 trial, metoprolol is already FDA-approved and proven effective, and this research seeks to understand how it benefits more patients.

The trial information does not specify if you need to stop taking your current medications. However, if you are on beta blockers or antihypertensive medications, you might need to discuss this with the trial team, as certain conditions related to these medications are part of the exclusion criteria.

Research has shown that metoprolol is generally safe for use. This medication often treats high blood pressure and other heart issues. Studies have found that metoprolol can lower the risk of death by 34% compared to a placebo over a year for certain heart conditions.

However, metoprolol can cause side effects. Common ones include dizziness, lightheadedness, or fainting, especially when standing up quickly. Other side effects might include fatigue, weakness, or mood changes. In some cases, it can cause low blood pressure or worsen heart failure symptoms, so monitoring by a doctor is important.

Researchers are excited about Metoprolol for treating fainting because it targets the heart's beta-receptors, potentially stabilizing heart rate and blood pressure more effectively than current treatments. Unlike standard options for fainting, which often focus on lifestyle changes or medications like fludrocortisone and midodrine, Metoprolol directly addresses the cardiovascular system's role in fainting. This direct approach could offer a more targeted solution, reducing symptoms and improving quality of life for those affected by frequent fainting episodes.

Research has shown that metoprolol, one of the treatments studied in this trial, may help reduce fainting in older adults. Studies have found that beta blockers like metoprolol can prevent fainting in this age group. A detailed review of several studies found that metoprolol significantly lowered the risk of fainting, with a hazard ratio of 0.52, indicating a reduced chance of fainting. The review also noted that metoprolol might be more effective for individuals aged 42 and older. While some studies found limited evidence of metoprolol's overall effectiveness in reducing fainting symptoms, the age-specific benefits suggest it could be valuable for older patients. Participants in this trial will receive either metoprolol or a matching placebo to further evaluate its effectiveness.¹³⁶⁷⁸