To the Editor.
—Orthostatic hypotension (OH) during diabetic autonomic neuropathy is frequent, treated with difficulty,1 and associated with a high death rate.2 Recently, indomethacin therapy has been proposed, but it is not devoid of side effects and exposes patients who already have a high risk of vascular diseases to clinostatic hypertension and coronary vasocon-striction.3 Metoclopramide dichlorhydrate therapy has been used with success in a case of severe OH after an extensive sympathectomy.4 Therapy with metoclopramide has frequent side effects, however.5 Domperidone, which antagonizes dopaminergic transmission, does not cross the blood-brain barrier6 and, theoretically, would be more easily tolerated. Therefore, we decided to treat a patient with diabetic OH by domperidone therapy.
Report of a Case.
—In November 1982, ketoacidosis diabetes was discovered in a 70-year-old woman with bilateral cataract, arthritis in her lower limbs, and ulceration of the soles of her feet.Blood
Alain Destee, Didier Leys, Brigitte Delisse, Pierre Warot. Orthostatic Hypotension due to Diabetic Autonomic Neuropathy? Treatment With Domperidone. Arch Neurol. 1987;44(1):11. doi:10.1001/archneur.1987.00520130007002