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January 1987

Orthostatic Hypotension due to Diabetic Autonomic Neuropathy? Treatment With Domperidone

Author Affiliations

Department of Neurology Lille University Hospital 2, Avenue Oscar Lambret F-59037 Lille Cedex, France

Arch Neurol. 1987;44(1):11. doi:10.1001/archneur.1987.00520130007002

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

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